Provider Demographics
NPI:1710336490
Name:WEST, ANGELA (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:VANCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7529 STANDISH PL STE 355
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20855-2733
Mailing Address - Country:US
Mailing Address - Phone:571-317-1742
Mailing Address - Fax:
Practice Address - Street 1:7529 STANDISH PL STE 355
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20855-2733
Practice Address - Country:US
Practice Address - Phone:571-317-1742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-03
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLBA203103K00000X
VA0133000718103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst