Provider Demographics
NPI:1164628327
Name:HORACE, ANGELIQUE ROSHEA (MA, MSW)
Entity type:Individual
Prefix:MISS
First Name:ANGELIQUE
Middle Name:ROSHEA
Last Name:HORACE
Suffix:
Gender:F
Credentials:MA, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7218 DOWERY DELL WAY
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35473-0046
Mailing Address - Country:US
Mailing Address - Phone:901-634-2232
Mailing Address - Fax:
Practice Address - Street 1:103 CONTINENTAL PL STE 204
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-1041
Practice Address - Country:US
Practice Address - Phone:615-543-6589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2024-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health