Provider Demographics
NPI:1558074963
Name:KNOTH, ANGELA GARRETT
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:GARRETT
Last Name:KNOTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:DENISE
Other - Last Name:GARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1030 E AMHERST AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-1712
Mailing Address - Country:US
Mailing Address - Phone:720-369-6858
Mailing Address - Fax:
Practice Address - Street 1:1030 E AMHERST AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-1712
Practice Address - Country:US
Practice Address - Phone:720-369-6858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical