Provider Demographics
NPI:1801583737
Name:HANSARD, ANGEL
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:HANSARD
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 1:4925 JACKMAN RD STE 3
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-3557
Mailing Address - Country:US
Mailing Address - Phone:313-686-1186
Mailing Address - Fax:
Practice Address - Street 1:4925 JACKMAN RD STE 3
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613-3557
Practice Address - Country:US
Practice Address - Phone:313-686-1186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-20
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty