Healthcare Provider Details

I. General information

NPI: 1679759724
Provider Name (Legal Business Name): ANGELA ATWATER DAMERON SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELA MICHELE ATWATER SLP

II. Dates (important events)

Enumeration Date: 01/18/2008
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E KING ST
HILLSBOROUGH NC
27278-2623
US

IV. Provider business mailing address

1503 WHITE CROSS RD 1503 WHITE CROSS RD
CHAPEL HILL NC
27516-7339
US

V. Phone/Fax

Practice location:
  • Phone: 919-245-4006
  • Fax:
Mailing address:
  • Phone: 919-270-2304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4218
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: