Individual
KATHE ANGELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
608 MARLENE DR, HOLLY HILL, FL 32117-3451
(386) 453-0250
Mailing address
PO BOX 238347, PORT ORANGE, FL 32123-8347
(386) 453-0250
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA18957
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA18957
STATE LICENSE
FL
Enumeration date
08/16/2010
Last updated
08/16/2010
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