Provider Demographics
NPI:1801929658
Name:MINOR, ANGELA WOZNIAK (PHD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:WOZNIAK
Last Name:MINOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 SW ROBERTS COURT
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64082
Mailing Address - Country:US
Mailing Address - Phone:816-554-7887
Mailing Address - Fax:
Practice Address - Street 1:600 SW JEFFERSON STREET
Practice Address - Street 2:STE 206
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64063
Practice Address - Country:US
Practice Address - Phone:816-554-7705
Practice Address - Fax:816-554-7706
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPYR0476103TC0700X
KS0963103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
24579038OtherBLUE CROSS BLUE SHIELD