Provider Demographics
NPI:1326860362
Name:MANUELITO, ANGELIA VALENTINE (MSGC)
Entity type:Individual
Prefix:
First Name:ANGELIA
Middle Name:VALENTINE
Last Name:MANUELITO
Suffix:
Gender:F
Credentials:MSGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 GOLF COURSE RD NW APT C206
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-6557
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2400 UNSER BLVD SE STE 28100
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-4741
Practice Address - Country:US
Practice Address - Phone:505-217-3410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS