Provider Demographics
NPI:1760763387
Name:CREECH, ANGELA BRITT
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:BRITT
Last Name:CREECH
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 1:134 FOREST WALK WAY
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-6993
Mailing Address - Country:US
Mailing Address - Phone:704-799-9678
Mailing Address - Fax:
Practice Address - Street 1:134 FOREST WALK WAY
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-6993
Practice Address - Country:US
Practice Address - Phone:704-799-9678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist