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General NPI Number Information
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NPI Number | 1730556770
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Entity Type | Organization
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Legal Business Name | ANGELA WEBER
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Dates
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Enumeration Date | 08/25/2015
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Last Update Date | 08/25/2015
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Provider Practice Location Address
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Address Line | 10 SAINT JOHNS PL
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City | ORMOND BEACH
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State | FL
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Zip | 32176-2839
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Country | US
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Telephone | 386-882-2809
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Fax |
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Provider Business Mailing Address
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Address Line | 10 SAINT JOHNS PL
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City | ORMOND BEACH
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State | FL
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Zip | 32176-2839
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST ASSISTANT
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Name | ANGELA MARIA WEBER
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Credential |
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Telephone | 386-882-2809
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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 | SI 2640
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License Number State | FL
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