Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003830605 |
---|---|
Provider Name | Ms. Joella Mohrland Anglin |
First Address | The Dalles, OR 97058 |
Second Address | The Dalles, OR 97058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 16/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
025608000 | REGENCE BCBS (01) | OR |
166045 | HEALTH NET - MHN (01) | OR |
395666 | VALUE OPTIONS (01) | |
J159901 | PACIFIC SOURCE (01) | OR |
P00296613 | RR MEDICARE (01) | OR |
S24574 | (02) |