Provider Demographics
NPI:1396294989
Name:HARRELL, ANGELYN RHAMES (MS)
Entity type:Individual
Prefix:
First Name:ANGELYN
Middle Name:RHAMES
Last Name:HARRELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ANGELYN
Other - Middle Name:
Other - Last Name:RHAMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1445 BRIARWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-2656
Mailing Address - Country:US
Mailing Address - Phone:352-257-3733
Mailing Address - Fax:
Practice Address - Street 1:1445 BRIARWOOD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-2656
Practice Address - Country:US
Practice Address - Phone:706-341-1293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-24
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst