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General NPI Number Information
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NPI Number | 1285249938
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Entity Type | Individual
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Provider Name | ANGELICA MARIA PARLE-FRESQUEZ M.A., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 09/10/2020
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Last Update Date | 09/10/2020
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Provider Practice Location Address
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Address Line | EARLY CHILDHOOD ASSESSMENT CENTER - LIESER SCHOOL 301 S. LIESER RD
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City | VANCOUVER
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State | WA
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Zip | 98664
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Country | US
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Telephone | 360-313-4840
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Fax |
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Provider Business Mailing Address
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Address Line | 5908 NW 38TH AVE APT 213
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City | CAMAS
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State | WA
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Zip | 98607-5410
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Country | US
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Telephone | 713-305-0992
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 103695
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | LL61097245
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License Number State | WA
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