Basic Information
| Provider Information | |||||||||
| NPI: | 1225698632 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DILLS | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | DENISE | ||||||||
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| Credential: | B.A., PSCYHOLOGY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4911 HAVERWOOD LN APT 3226 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752874442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4143663177 | ||||||||
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| Practice Location | |||||||||
| Address1: | 320 WESTWAY PL | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760185245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8175169100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2019 | ||||||||
| LastUpdateDate: | 06/18/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.