Provider Demographics
NPI:1205144979
Name:BOUNDY, ANGELA M (MSED, BCBA)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:M
Last Name:BOUNDY
Suffix:
Gender:F
Credentials:MSED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8315 98TH ST APT 5J
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421-8405
Mailing Address - Country:US
Mailing Address - Phone:646-244-9203
Mailing Address - Fax:
Practice Address - Street 1:8315 98TH ST APT 5J
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-8405
Practice Address - Country:US
Practice Address - Phone:646-244-9203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency