Provider Demographics
NPI:1992062657
Name:MCCABE, ANGEL MARY (LMT)
Entity type:Individual
Prefix:
First Name:ANGEL
Middle Name:MARY
Last Name:MCCABE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7165 W KENTUCKY DR
Mailing Address - Street 2:UNIT E
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-4407
Mailing Address - Country:US
Mailing Address - Phone:720-341-2242
Mailing Address - Fax:
Practice Address - Street 1:7165 W KENTUCKY DR
Practice Address - Street 2:UNIT E
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-4407
Practice Address - Country:US
Practice Address - Phone:720-341-2242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2301225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist