Provider Demographics
NPI:1053151712
Name:ZOLMAN, ANGELA D (MS BCBA, LBA)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:D
Last Name:ZOLMAN
Suffix:
Gender:F
Credentials:MS BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 N FIRMAN ST
Mailing Address - Street 2:
Mailing Address - City:PARK HILLS
Mailing Address - State:MO
Mailing Address - Zip Code:63601-3703
Mailing Address - Country:US
Mailing Address - Phone:573-330-0295
Mailing Address - Fax:
Practice Address - Street 1:300 BERRY RD
Practice Address - Street 2:
Practice Address - City:BONNE TERRE
Practice Address - State:MO
Practice Address - Zip Code:63628-3580
Practice Address - Country:US
Practice Address - Phone:573-431-3300
Practice Address - Fax:573-534-0182
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024005681103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst