Provider Demographics
NPI:1295072783
Name:MENDEZ, ANGELA JOSEFINA (LAMFT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:JOSEFINA
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 MINNETONKA BLVD
Mailing Address - Street 2:APT 102
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-5711
Mailing Address - Country:US
Mailing Address - Phone:651-210-6549
Mailing Address - Fax:
Practice Address - Street 1:4725 MINNETONKA BLVD
Practice Address - Street 2:APT 102
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-5711
Practice Address - Country:US
Practice Address - Phone:651-210-6549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist