Individual
TAMMY ANGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
3997 BECKLEY RD, PRINCETON, WV 24740-7660
(304) 431-5499
(304) 431-3400
Mailing address
3997 BECKLEY RD, PRINCETON, WV 24740-7660
(304) 431-5499
(304) 431-3400
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005489001
—
WV
05
—
0005489002
—
WV
Enumeration date
10/31/2014
Last updated
06/09/2020
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