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General NPI Number Information
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NPI Number | 1447720677
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Entity Type | Individual
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Provider Name | DENICE ANGELA SANTA MARIA M.S. , CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 11/30/2018
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Last Update Date | 07/30/2021
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Provider Practice Location Address
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Address Line | 5659 STADIUM DR STE 2
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City | KALAMAZOO
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State | MI
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Zip | 49009-1932
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Country | US
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Telephone | 269-372-0436
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Fax |
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Provider Business Mailing Address
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Address Line | 2677 HICKORY NUT LN
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City | KALAMAZOO
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State | MI
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Zip | 49004-3739
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Country | US
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Telephone | 812-827-6774
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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 | 7101005541
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License Number State | MI
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