Provider Demographics
NPI:1447313572
Name:ANGELL, MARILYN ELIZABETH (MBA,RCST,NCMT)
Entity type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:ELIZABETH
Last Name:ANGELL
Suffix:
Gender:F
Credentials:MBA,RCST,NCMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 BAILEY RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-8639
Mailing Address - Country:US
Mailing Address - Phone:724-468-8578
Mailing Address - Fax:
Practice Address - Street 1:192 BAILEY RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-8639
Practice Address - Country:US
Practice Address - Phone:724-468-8578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA290211-00 NATIONAL225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist