Provider Demographics
NPI:1184280562
Name:STUTZMAN-RALEY, ANGELA (LPC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:STUTZMAN-RALEY
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 1:112 RIVERVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BLAWNOX
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2735
Mailing Address - Country:US
Mailing Address - Phone:724-762-9316
Mailing Address - Fax:
Practice Address - Street 1:1229 SILVER LN
Practice Address - Street 2:
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1007
Practice Address - Country:US
Practice Address - Phone:724-762-9316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-12
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011381101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional