Provider Demographics
NPI:1992377543
Name:NORDIN, ANGELA ABLA (LPC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:ABLA
Last Name:NORDIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1219 LARKSPUR DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-3610
Mailing Address - Country:US
Mailing Address - Phone:469-831-7758
Mailing Address - Fax:
Practice Address - Street 1:1219 LARKSPUR DR
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-3610
Practice Address - Country:US
Practice Address - Phone:469-831-7758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79245101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty