Provider Demographics
NPI:1356982755
Name:BARRETT, ANGEL MICHELLE
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:MICHELLE
Last Name:BARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 CEDAR KNOLL RD
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-1019
Mailing Address - Country:US
Mailing Address - Phone:484-516-5108
Mailing Address - Fax:
Practice Address - Street 1:711 CEDAR KNOLL RD
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-1019
Practice Address - Country:US
Practice Address - Phone:484-516-5108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)