Provider Demographics
NPI:1588857270
Name:SHEBLE, ANGELA TERRY (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:TERRY
Last Name:SHEBLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15814 SPRING CREST CIR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-1655
Mailing Address - Country:US
Mailing Address - Phone:813-963-3931
Mailing Address - Fax:813-963-3931
Practice Address - Street 1:15814 SPRING CREST CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-1655
Practice Address - Country:US
Practice Address - Phone:813-963-3931
Practice Address - Fax:813-963-3931
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-25
Last Update Date:2007-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS 890103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool