Provider Demographics
NPI:1598072258
Name:TIGER, ANGELLA A
Entity Type:Individual
Prefix:
First Name:ANGELLA
Middle Name:A
Last Name:TIGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6209 PEPPERMILL DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-3049
Mailing Address - Country:US
Mailing Address - Phone:702-274-0427
Mailing Address - Fax:702-644-6031
Practice Address - Street 1:2 NW ALSEA BAY DR
Practice Address - Street 2:
Practice Address - City:WALDPORT
Practice Address - State:OR
Practice Address - Zip Code:97394-9446
Practice Address - Country:US
Practice Address - Phone:702-274-0427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst