Provider Demographics
NPI:1104105121
Name:OSTRANDER, ANGELA E (PSYD, LMFT, LMHC)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:E
Last Name:OSTRANDER
Suffix:
Gender:F
Credentials:PSYD, LMFT, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6152 DELANCEY STATION ST STE 206
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-4206
Mailing Address - Country:US
Mailing Address - Phone:813-385-1223
Mailing Address - Fax:
Practice Address - Street 1:6152 DELANCEY STATION ST STE 206
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-4206
Practice Address - Country:US
Practice Address - Phone:813-385-1223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X, 390200000X
FLMH19876101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program