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Individual

ANGELIQUE JADE ANGEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
175 STONEBRIDGE LN STE 140, SOUTHLAKE, TX 76092-0318
(855) 782-7822
Mailing address
6800 GREENACRES DR, NORTH RICHLAND HILLS, TX 76182-7613
(817) 789-8128

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
04/19/2024
Last updated
04/07/2025
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