MEDICARE: ANGELA CAMPO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP.16207	OH

General Provider Information

NPI Number	:	1093647539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA CAMPO

Provider Business Mailing Address
First Line	:	955 W SAINT CLAIR AVE APT 1616
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-1240
Country	:	US
Telephone Number	:	440-668-5026
Fax Number	:

Provider Business Practice Location Address
First Line	:	1957 COOPER FOSTER PARK RD STE A
Second Line	:
City	:	AMHERST
State	:	OH
Zip	:	44001-1216
Country	:	US
Telephone Number	:	440-960-3400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ ANGELA CAMPO ” Practice Location

Language	Start Address	Practice Location

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