Provider Demographics
NPI:1992591846
Name:HAMBERLIN, ANGELA MARCIA
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARCIA
Last Name:HAMBERLIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 ITALIA LN
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-0942
Mailing Address - Country:US
Mailing Address - Phone:972-855-8097
Mailing Address - Fax:
Practice Address - Street 1:5000 ITALIA LN
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-0942
Practice Address - Country:US
Practice Address - Phone:972-890-1928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90482101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional