Provider Demographics
NPI:1720664550
Name:ANGELOSANTE, COURTNEY (BCBA)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:ANGELOSANTE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 SNOWS CORNER RD
Mailing Address - Street 2:
Mailing Address - City:ORRINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04474-3222
Mailing Address - Country:US
Mailing Address - Phone:207-660-5483
Mailing Address - Fax:
Practice Address - Street 1:223 SNOWS CORNER RD
Practice Address - Street 2:
Practice Address - City:ORRINGTON
Practice Address - State:ME
Practice Address - Zip Code:04474-3222
Practice Address - Country:US
Practice Address - Phone:207-660-5483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst