Provider Demographics
NPI:1336612381
Name:PAGGETT, ANGELA SADA' DEMOIN (LMFT)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:SADA' DEMOIN
Last Name:PAGGETT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 JOHN WESLEY AVE
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30337-3605
Mailing Address - Country:US
Mailing Address - Phone:404-762-9190
Mailing Address - Fax:
Practice Address - Street 1:1800 LAKE PARK DR SE STE 123
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-7639
Practice Address - Country:US
Practice Address - Phone:404-905-1755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
GAMFT002047106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist