Provider Demographics
NPI:1821683202
Name:BERKTOLD, ANGELA (MT-BC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:BERKTOLD
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:
Other - Last Name:BERKTOLD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3286 W MONMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-6335
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3286 W MONMOUTH AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-6335
Practice Address - Country:US
Practice Address - Phone:651-380-7579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-07
Last Update Date:2021-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist