Provider Demographics
NPI:1003459819
Name:ANGLE, CLAIRE PRESLEY (LMFT)
Entity type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:PRESLEY
Last Name:ANGLE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:P
Other - Last Name:ANGLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:1371 ORCHARD HILL RD
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-2551
Mailing Address - Country:US
Mailing Address - Phone:478-320-8158
Mailing Address - Fax:478-445-6062
Practice Address - Street 1:1371 ORCHARD HILL RD
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-2551
Practice Address - Country:US
Practice Address - Phone:478-320-8158
Practice Address - Fax:478-445-6062
Is Sole Proprietor?:No
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT000927106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist