Individual
MS. ANGELA TELLEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QMHS
Contact information
Practice address
1045 KLOTZ RD, BOWLING GREEN, OH 43402-4820
(419) 889-1316
Mailing address
1045 KLOTZ RD, BOWLING GREEN, OH 43402-4820
(419) 352-7588
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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