Provider Demographics
NPI:1578865879
Name:PRIETO, ANGELA MARIA (BA)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:MARIA
Last Name:PRIETO
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11609 VILLA MALAPARTE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-6009
Mailing Address - Country:US
Mailing Address - Phone:702-506-7110
Mailing Address - Fax:
Practice Address - Street 1:1221 KILAUEA AVE STE 60
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4264
Practice Address - Country:US
Practice Address - Phone:808-315-1339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-19
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health