Provider Demographics
NPI:1033608260
Name:CAPUANO-FANT, ANGELA LEIGH (PHD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:LEIGH
Last Name:CAPUANO-FANT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 STONE CANYON CT
Mailing Address - Street 2:
Mailing Address - City:HINCKLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44233-9229
Mailing Address - Country:US
Mailing Address - Phone:216-336-2049
Mailing Address - Fax:
Practice Address - Street 1:246 STONE CANYON CT
Practice Address - Street 2:
Practice Address - City:HINCKLEY
Practice Address - State:OH
Practice Address - Zip Code:44233-9229
Practice Address - Country:US
Practice Address - Phone:216-336-2049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.08615103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist