Provider Demographics
NPI:1932479078
Name:DELAFUENTE, ANGELINA LAUREL
Entity Type:Individual
Prefix:
First Name:ANGELINA
Middle Name:LAUREL
Last Name:DELAFUENTE
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 1:441 CHENEY ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-0911
Mailing Address - Country:US
Mailing Address - Phone:775-322-4223
Mailing Address - Fax:775-322-8044
Practice Address - Street 1:441 CHENEY ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-0911
Practice Address - Country:US
Practice Address - Phone:775-322-4223
Practice Address - Fax:775-322-8044
Is Sole Proprietor?:No
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner