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Individual

ANGELA KAY WILLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LISW

Contact information

Practice address
244 S CHESTNUT ST, BARNESVILLE, OH 43713-1323
(740) 238-0628
Mailing address
35159 BURKHART RD, BARNESVILLE, OH 43713-9796
(740) 425-2834

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
BP00943050
WV
1041C0700X
Clinical Social Worker
Primary
I 1000307
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002009594
BCBS
WV
Enumeration date
01/03/2008
Last updated
12/02/2010
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