Provider Demographics
NPI:1417725755
Name:ANGLON-COLEMAN, H. SARON DANIEL
Entity type:Individual
Prefix:
First Name:H. SARON
Middle Name:DANIEL
Last Name:ANGLON-COLEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARON
Other - Middle Name:DANIELLE
Other - Last Name:ANGLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 S WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-3954
Mailing Address - Country:US
Mailing Address - Phone:575-526-2819
Mailing Address - Fax:575-526-8542
Practice Address - Street 1:800 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-3954
Practice Address - Country:US
Practice Address - Phone:575-526-2819
Practice Address - Fax:575-526-8542
Is Sole Proprietor?:No
Enumeration Date:2023-12-15
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician