Provider Demographics
NPI:1720826605
Name:PRITCHARD, ANGELA R (PRS)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:R
Last Name:PRITCHARD
Suffix:
Gender:F
Credentials:PRS
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:R
Other - Last Name:MOSELEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:625 CLEVELAND AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44702-1805
Mailing Address - Country:US
Mailing Address - Phone:330-455-0374
Mailing Address - Fax:330-453-6716
Practice Address - Street 1:1711 SPRING AVE NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44714-2349
Practice Address - Country:US
Practice Address - Phone:330-454-6800
Practice Address - Fax:330-588-7176
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.005158175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist