Provider Demographics
NPI:1841616448
Name:REBEKAH ANGLE
Entity Type:Organization
Organization Name:REBEKAH ANGLE
Other - Org Name:REBEKAH J. INMAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGLE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:703-919-0818
Mailing Address - Street 1:8420 DORSEY CIR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-8300
Mailing Address - Country:US
Mailing Address - Phone:703-919-0818
Mailing Address - Fax:
Practice Address - Street 1:8420 DORSEY CIR
Practice Address - Street 2:SUITE 201
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-8300
Practice Address - Country:US
Practice Address - Phone:703-919-0818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-07
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004958103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty