Angelique Jade Angel

NPI #1962257279 in Southlake, Texas

Provider Information

NPI Number: 1962257279
Entity Type: Individual
Name: Angelique Jade Angel
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Apr 19, 2024
Last Updated: Apr 7, 2025

Practice Location

Address: 175 STONEBRIDGE LN STE 140
City: Southlake
State: Texas
ZIP Code: 76092-0318
Phone: (855) 782-7822

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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