Provider Demographics
NPI:1679027668
Name:KENZSLOWE, ANGELA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:KENZSLOWE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7860 E CAMELBACK RD UNIT 310
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-2262
Mailing Address - Country:US
Mailing Address - Phone:602-435-3909
Mailing Address - Fax:
Practice Address - Street 1:7860 E CAMELBACK RD UNIT 310
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-2262
Practice Address - Country:US
Practice Address - Phone:602-435-3909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-08
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4757103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical