Provider Demographics
NPI:1588818926
Name:SUTTON, ANGEL L (MS)
Entity Type:Individual
Prefix:MS
First Name:ANGEL
Middle Name:L
Last Name:SUTTON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2008
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37070-2008
Mailing Address - Country:US
Mailing Address - Phone:615-586-7215
Mailing Address - Fax:615-528-1001
Practice Address - Street 1:115 VINE LN
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-4166
Practice Address - Country:US
Practice Address - Phone:615-586-7215
Practice Address - Fax:615-528-1001
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst