Provider Demographics
NPI:1265706972
Name:REED, ANGELA (CLINICAL SUPERVISOR)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:CLINICAL SUPERVISOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8383 GREENWAY BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-4659
Mailing Address - Country:US
Mailing Address - Phone:608-444-1717
Mailing Address - Fax:608-465-4021
Practice Address - Street 1:8383 GREENWAY BLVD STE 600
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-4659
Practice Address - Country:US
Practice Address - Phone:608-444-1717
Practice Address - Fax:608-465-4021
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-27
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor