Individual
ANGELA FELLOWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1 JARRETT WHITE RD, TRIPLER AMC, HI 96859-5001
(808) 433-9209
Mailing address
5880 HIGHWAY 67 S, FLORENCE, CO 81290-1000
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
51756
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346707320
TRICARE
TX
01
—
51756
BLUE CROSS BLUE SHEILD
TX
05
—
51756
—
TX
Enumeration date
02/26/2019
Last updated
02/22/2023
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