Provider Demographics
NPI:1568237774
Name:WHIPPLE, ANGELA
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:WHIPPLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:WHIPPLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CEO
Mailing Address - Street 1:5227 HINDEL LN
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110
Mailing Address - Country:US
Mailing Address - Phone:614-512-2336
Mailing Address - Fax:
Practice Address - Street 1:5227 HINDEL LN
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110
Practice Address - Country:US
Practice Address - Phone:614-512-2336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No132700000XDietary & Nutritional Service ProvidersDietary Manager