Provider Demographics
NPI:1922566595
Name:VITERI, ANGELA CARMEN
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:CARMEN
Last Name:VITERI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:CARMEN
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1729 W GREENTREE DR STE 103
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-2712
Mailing Address - Country:US
Mailing Address - Phone:602-666-5101
Mailing Address - Fax:
Practice Address - Street 1:1729 W GREENTREE DR STE 103
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-2712
Practice Address - Country:US
Practice Address - Phone:602-666-5101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-03
Last Update Date:2019-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst