Individual
ANGELA B WALLENBROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1570 HEATHERWAE LOOP, POWELL, OH 43065-9363
(614) 432-6410
Mailing address
1570 HEATHERWAE LOOP, POWELL, OH 43065-9363
(614) 432-6410
(614) 430-5744
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35049858W
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0599320
—
OH
Enumeration date
01/23/2006
Last updated
10/21/2024
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