Provider Demographics
NPI:1134398548
Name:PRICE, ANGELA DAWN (LSW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:DAWN
Last Name:PRICE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13A HIDDEN VLY
Mailing Address - Street 2:
Mailing Address - City:KENOVA
Mailing Address - State:WV
Mailing Address - Zip Code:25530-9787
Mailing Address - Country:US
Mailing Address - Phone:304-617-6672
Mailing Address - Fax:304-617-6672
Practice Address - Street 1:13A HIDDEN VLY
Practice Address - Street 2:
Practice Address - City:KENOVA
Practice Address - State:WV
Practice Address - Zip Code:25530-9787
Practice Address - Country:US
Practice Address - Phone:304-617-6672
Practice Address - Fax:304-617-6672
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator