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General NPI Number Information
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NPI Number | 1639496375
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Entity Type | Organization
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Legal Business Name | SPEECH & LANGUAGE BY ANGELICA, CORP.
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Dates
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Enumeration Date | 04/20/2010
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Last Update Date | 12/11/2013
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Provider Practice Location Address
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Address Line | 819 SW 147TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-6127
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Country | US
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Telephone | 954-709-5403
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Fax | 954-589-1475
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Provider Business Mailing Address
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Address Line | 819 SW 147TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-6127
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Country | US
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Telephone | 954-709-5403
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Fax | 954-589-1475
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Authorized Official
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Title or Position | SPEECH AND LANGUAGE PATHOLOGIST
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Name | MRS. ANGELA SHETROMPF
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Credential | M.S., CCC- SLP
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Telephone | 954-709-5403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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