MEDICARE: ALEXANDRA A ANGELES

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	22009023A	IN

General Provider Information

NPI Number	:	1629886650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA A ANGELES

Provider Business Mailing Address
First Line	:	2692 W COUNTY ROAD 250 S
Second Line	:
City	:	CONNERSVILLE
State	:	IN
Zip	:	47331-8749
Country	:	US
Telephone Number	:	765-698-4524
Fax Number	:

Provider Business Practice Location Address
First Line	:	2909 N 118TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68164-3620
Country	:	US
Telephone Number	:	402-509-5532
Fax Number	:

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

Provider Enumeration Date	:	12/23/2024
Last Update Date	:	12/23/2024

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Directions to “ ALEXANDRA A ANGELES ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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