Provider Demographics
NPI:1841788049
Name:DECUNZO, ANGELA FRANCIS
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:FRANCIS
Last Name:DECUNZO
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 1:3317 S LAREDO CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-1913
Mailing Address - Country:US
Mailing Address - Phone:720-220-4290
Mailing Address - Fax:
Practice Address - Street 1:9123 E MISSISSIPPI AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-2088
Practice Address - Country:US
Practice Address - Phone:619-504-0204
Practice Address - Fax:720-500-6094
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician