Provider Demographics
NPI:1871806752
Name:DARNELL, ANGELA SUE (MS, CGC)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:SUE
Last Name:DARNELL
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:SUE
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11820 VILLAGE POND DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-7678
Mailing Address - Country:US
Mailing Address - Phone:704-587-3669
Mailing Address - Fax:
Practice Address - Street 1:1718 E 4TH ST STE 404
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3193
Practice Address - Country:US
Practice Address - Phone:704-384-5731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12717170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS