Provider Demographics
NPI:1073328472
Name:TERRELL, ANGEL JAMESHA (N/A)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:JAMESHA
Last Name:TERRELL
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ASPEN CT APT 216
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-8631
Mailing Address - Country:US
Mailing Address - Phone:205-725-3075
Mailing Address - Fax:
Practice Address - Street 1:15 ASPEN CT APT 216
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-8631
Practice Address - Country:US
Practice Address - Phone:205-725-3075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician