Provider Demographics
NPI:1922369628
Name:PANGELINAN, HOPE MARIE JACOSALEM (MSW)
Entity Type:Individual
Prefix:MS
First Name:HOPE MARIE
Middle Name:JACOSALEM
Last Name:PANGELINAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O.B. 5107 UOG STATION
Mailing Address - Street 2:
Mailing Address - City:MANGILAO
Mailing Address - State:GUAM
Mailing Address - Zip Code:96923
Mailing Address - Country:UM
Mailing Address - Phone:671-988-9312
Mailing Address - Fax:
Practice Address - Street 1:124 KASOY CT
Practice Address - Street 2:
Practice Address - City:DEDEDO
Practice Address - State:GU
Practice Address - Zip Code:96929-5815
Practice Address - Country:US
Practice Address - Phone:671-988-9312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUIMF-120106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist