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Individual
ANGELA EVELYN GARDNER
Active
Individual
ANGELA EVELYN GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
BBH-LCSW-LIC-42766
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689214090
—
MT
Enumeration date
01/14/2020
Last updated
07/27/2021
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