Provider Demographics
NPI:1740673847
Name:WARR, ANGELA FAYE (AMS)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:FAYE
Last Name:WARR
Suffix:
Gender:F
Credentials:AMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 700874
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75370-0874
Mailing Address - Country:US
Mailing Address - Phone:972-741-3760
Mailing Address - Fax:
Practice Address - Street 1:4524 LEE ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4157
Practice Address - Country:US
Practice Address - Phone:972-741-3760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-13
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXCAMS-S103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst