Individual
MRS. LISA ANN ANGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1100-1 PONCE DE LEON BOULEVARD, ST. AUGUSTINE, FL 32084
(904) 824-7733
(904) 829-9768
Mailing address
1100-1 PONCE DE LEON BOULEVARD, ST. AUGUSTINE, FL 32084
(904) 824-7733
(904) 829-9768
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT2232
FL
Other
Enumeration date
01/23/2008
Last updated
01/23/2008
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