Provider Demographics
NPI:1700153053
Name:JOLICOEUR, ANGELA KAREN
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:KAREN
Last Name:JOLICOEUR
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 1:2633 S HALIFAX CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-6263
Mailing Address - Country:US
Mailing Address - Phone:813-312-2188
Mailing Address - Fax:
Practice Address - Street 1:2633 S HALIFAX CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-6263
Practice Address - Country:US
Practice Address - Phone:813-312-2188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health