Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist |
NPI | 1255937330 |
---|---|
Provider Name | Angela Totos |
First Address | Highland, IN 46322-1631 |
Second Address | Highland, IN 46322-1631 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2020 |
Last Update Date | 04/12/2020 |