Healthcare Provider Details

I. General information

NPI: 1346570033
Provider Name (Legal Business Name): ANGELA D TIWARI SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2010
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31514 CHESAPEAKE BAY DR
WESLEY CHAPEL FL
33543-4050
US

IV. Provider business mailing address

31514 CHESAPEAKE BAY DR
WESLEY CHAPEL FL
33543-4050
US

V. Phone/Fax

Practice location:
  • Phone: 954-557-5846
  • Fax:
Mailing address:
  • Phone: 954-557-5846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA7499
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: