Provider Demographics
NPI:1881957934
Name:DUDLEY HAMILTON, ANGELA TERESA (LCPC)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:TERESA
Last Name:DUDLEY HAMILTON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MS
Other - First Name:ANGELA
Other - Middle Name:TERESA
Other - Last Name:DUDLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11415 OLD POND DRIVE
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769
Mailing Address - Country:US
Mailing Address - Phone:202-746-4345
Mailing Address - Fax:
Practice Address - Street 1:11415 OLD POND DRIVE
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769
Practice Address - Country:US
Practice Address - Phone:202-746-4345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14272101YP2500X
MDLC4492101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional