Provider Demographics
NPI:1457421828
Name:MACCABE, ANGELA GADD (PT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:GADD
Last Name:MACCABE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:MACKABEN
Other - Last Name:FELKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3773 BAKER LN
Mailing Address - Street 2:SUITE 2
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-5449
Mailing Address - Country:US
Mailing Address - Phone:775-825-1316
Mailing Address - Fax:775-825-1316
Practice Address - Street 1:10509 PROFESSIONAL CIRCLE
Practice Address - Street 2:SUITE 101
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-5449
Practice Address - Country:US
Practice Address - Phone:775-313-9120
Practice Address - Fax:810-931-2498
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1585225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist