Provider Demographics
NPI:1902363765
Name:ANTHONY SILLS, ANGELINA (DRPH)
Entity Type:Individual
Prefix:
First Name:ANGELINA
Middle Name:
Last Name:ANTHONY SILLS
Suffix:
Gender:F
Credentials:DRPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8405 HORATIO RD
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-4526
Mailing Address - Country:US
Mailing Address - Phone:443-271-4853
Mailing Address - Fax:
Practice Address - Street 1:2815 SAINT LO DR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1325
Practice Address - Country:US
Practice Address - Phone:443-642-2291
Practice Address - Fax:410-338-2956
Is Sole Proprietor?:No
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD034101041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool