Provider Demographics
NPI:1578898821
Name:PEREIRA, ANGELA KLIMICK (LAC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:KLIMICK
Last Name:PEREIRA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:GIGI
Other - Middle Name:KLIMICK
Other - Last Name:PEREIRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:3200 BURNET AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3019
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3113 BELLEVUE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-3158
Practice Address - Country:US
Practice Address - Phone:513-834-8173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH65.000160171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist