Healthcare Provider Details

I. General information

NPI: 1558279794
Provider Name (Legal Business Name): ANNA ANGLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1854 AUBURN RD STE 101
DACULA GA
30019-1130
US

IV. Provider business mailing address

4935 HOPEWELL MANOR DR
CUMMING GA
30028-4071
US

V. Phone/Fax

Practice location:
  • Phone: 770-904-6009
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: