Provider Demographics
NPI:1649772823
Name:HUBER, ANGELA ARMENTROUT
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:ARMENTROUT
Last Name:HUBER
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 1:6801 UNION MILL RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:VA
Mailing Address - Zip Code:20124-1118
Mailing Address - Country:US
Mailing Address - Phone:703-988-8222
Mailing Address - Fax:
Practice Address - Street 1:6801 UNION MILL RD
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:VA
Practice Address - Zip Code:20124-1118
Practice Address - Country:US
Practice Address - Phone:703-988-8222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAPPS-5686811041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPPS-568861OtherSCHOOL PUPIL LICENSE