Provider Demographics
NPI:1316694938
Name:LONDONO, ANGELINA I (PHD, NBC-HWC)
Entity type:Individual
Prefix:
First Name:ANGELINA
Middle Name:I
Last Name:LONDONO
Suffix:
Gender:F
Credentials:PHD, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3041 WESTFOREST DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-2449
Mailing Address - Country:US
Mailing Address - Phone:205-276-6359
Mailing Address - Fax:
Practice Address - Street 1:201 MILFORD MILL RD STE 102
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-5902
Practice Address - Country:US
Practice Address - Phone:443-898-6562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174H00000X
TXA-3489111
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No174H00000XOther Service ProvidersHealth Educator