Provider Demographics
NPI:1396340592
Name:PYLES, ANGELA MARIE (RCSWI)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:PYLES
Suffix:
Gender:F
Credentials:RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3049 CLEVELAND AVE STE 165
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-7044
Mailing Address - Country:US
Mailing Address - Phone:239-839-3907
Mailing Address - Fax:
Practice Address - Street 1:3049 CLEVELAND AVE UNIT 170
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-7041
Practice Address - Country:US
Practice Address - Phone:239-839-3907
Practice Address - Fax:239-936-0114
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRCSWI1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical