Individual
MRS. ANGIE MARIE MASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.I.
Contact information
Practice address
846 KING RD, MAYFIELD, KY 42066-6688
(270) 623-8302
Mailing address
846 KING RD, MAYFIELD, KY 42066-6688
(270) 623-8302
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1721
FIRST STEPS
KY
Enumeration date
04/16/2008
Last updated
04/19/2008
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