Pence, Angela Diane
Pence, Angela Diane is an individual health care provider with primary practice located at 720 14Th Ave , Longview WA 98632-2315. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Pence, Angela Diane can be contacted via phone (360) 577-0249.Contact Information
Primary practice address
720 14Th Ave
Longview WA 98632-2315
Phone: (360) 577-0249
Fax: (360) 577-0269
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | 60935956 | Washington |
Profile Details
| NPI number | 1750763256 |
|---|---|
| LBN Legal business name | Pence, Angela Diane |
| Credentials | MSW, LICSW, DMHP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2015 |
| Last updated | Nov 7th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750763256 | NPPES |
| Washington | MEDICAID | 2140670 |
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