Provider Demographics
NPI:1154032431
Name:CHAMBERS, ANGELINE LETITIA (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:ANGELINE
Middle Name:LETITIA
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 GOVERNOR MORRISON ST APT 485
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-0003
Mailing Address - Country:US
Mailing Address - Phone:704-779-2159
Mailing Address - Fax:
Practice Address - Street 1:721 GOVERNOR MORRISON ST APT 485
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-0003
Practice Address - Country:US
Practice Address - Phone:704-779-2159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15542225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist