Provider Demographics
NPI:1396571279
Name:EVANS, ANGELA ROCHELLE (RBT)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:ROCHELLE
Last Name:EVANS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MISS
Other - First Name:ANGELA
Other - Middle Name:ROCHELLE
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:315 E AVENUE G
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76541-6152
Mailing Address - Country:US
Mailing Address - Phone:714-306-1169
Mailing Address - Fax:
Practice Address - Street 1:315 E AVENUE G
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-6152
Practice Address - Country:US
Practice Address - Phone:714-306-1169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-24-374382106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician