Provider Demographics
NPI:1043567308
Name:SEGAL, ANGELA (PHD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:SEGAL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 WILLARD AVE
Mailing Address - Street 2:SUITE 1113
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-3611
Mailing Address - Country:US
Mailing Address - Phone:301-219-5917
Mailing Address - Fax:
Practice Address - Street 1:4701 WILLARD AVE
Practice Address - Street 2:SUITE 227
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4643
Practice Address - Country:US
Practice Address - Phone:301-219-5917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05011103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist