Individual
MRS. VIJAYA VENKATA TANGELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
739 CHAPPELL DR, RALEIGH, NC 27606-3215
(919) 832-3909
(919) 832-3035
Mailing address
739 CHAPPELL DR, RALEIGH, NC 27606-3215
(919) 832-3909
(919) 832-3035
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
1439
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14195
BCBS OF NC
NC
05
—
6107363
—
NC
Enumeration date
11/30/2006
Last updated
07/09/2007
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