Provider Demographics
NPI:1700657046
Name:LEE-BARBER, ANGEL CHRISTINE
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:CHRISTINE
Last Name:LEE-BARBER
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 1:6 CLAYMORE DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-2103
Mailing Address - Country:US
Mailing Address - Phone:757-770-3863
Mailing Address - Fax:
Practice Address - Street 1:1030 LOFTIS BLVD STE 103
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2999
Practice Address - Country:US
Practice Address - Phone:757-772-0009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician