Provider Demographics
NPI:1578283115
Name:GELIN, ANGELA DC (LAC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:DC
Last Name:GELIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2033 BROADACRES DR
Mailing Address - Street 2:
Mailing Address - City:CLEMENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-5629
Mailing Address - Country:US
Mailing Address - Phone:609-369-4679
Mailing Address - Fax:
Practice Address - Street 1:860 ROUTE 168 STE 104
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-3224
Practice Address - Country:US
Practice Address - Phone:856-677-8535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00670200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional