Provider Demographics
NPI:1932890134
Name:BOSWELL, ANGELA CHAMPAGNE (MSW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:CHAMPAGNE
Last Name:BOSWELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 E TUMBLEWEED DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-7785
Mailing Address - Country:US
Mailing Address - Phone:310-796-6577
Mailing Address - Fax:
Practice Address - Street 1:7420 E CAMELBACK RD STE 103
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3509
Practice Address - Country:US
Practice Address - Phone:480-300-2635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker