Provider Demographics
NPI:1548706278
Name:FELICIANO, ANGELA MARIA (LMSW)
Entity type:Individual
Prefix:
First Name:ANGELA MARIA
Middle Name:
Last Name:FELICIANO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 SHELTER GROVE CIR
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-8249
Mailing Address - Country:US
Mailing Address - Phone:406-585-5321
Mailing Address - Fax:
Practice Address - Street 1:8 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3322
Practice Address - Country:US
Practice Address - Phone:406-585-5321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical