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Individual

ANGELA LYNN WARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1141 DINSMORE ST, NORTH PORT, FL 34288-6844
(941) 769-0810
Mailing address
1141 DINSMORE ST, NORTH PORT, FL 34288-6844
(941) 769-0810

Taxonomy

Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
101669300
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101669300
FL
Enumeration date
02/11/2019
Last updated
02/11/2019
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