Provider Demographics
NPI:1194923854
Name:HOWARD, ANGELA DEE (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:DEE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5905 GOLDEN VALLEY RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4463
Mailing Address - Country:US
Mailing Address - Phone:763-225-4047
Mailing Address - Fax:763-546-2774
Practice Address - Street 1:5905 GOLDEN VALLEY RD
Practice Address - Street 2:SUITE 110
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-4463
Practice Address - Country:US
Practice Address - Phone:763-225-4047
Practice Address - Fax:763-546-2774
Is Sole Proprietor?:No
Enumeration Date:2007-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN169611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical