Individual
ANGELA BACAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.S
Contact information
Practice address
145 N QUENTIN RD, NEWARK, OH 43055-4623
(740) 349-6084
Mailing address
6986 POLPIS RD, REYNOLDSBURG, OH 43068-7170
(330) 503-6241
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
OH3282914
OH
Other
Enumeration date
08/19/2018
Last updated
08/19/2018
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