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NPI Code Detail

MEDICARE: ANGELA DAWN LABAJ MS, CCC-SLP

MEDICARE: ANGELA DAWN LABAJ MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist110663TX

General Provider Information

NPI Number : 1790251882
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA DAWN LABAJ MS, CCC-SLP
Provider Business Mailing Address
First Line : 3410 MEADOW CREEK LN
Second Line :
City : TEMPLE
State : TX
Zip : 76504-2162
Country : US
Telephone Number : 254-742-5061
Fax Number :
Provider Business Practice Location Address
First Line : 7349 HONEYSUCKLE STE 100
Second Line :
City : TEMPLE
State : TX
Zip : 76502-5888
Country : US
Telephone Number : 254-780-9658
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2018
Last Update Date : 10/16/2018

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Directions to “ ANGELA DAWN LABAJ MS, CCC-SLP” Practice Location

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