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NPI Code Detail

MEDICARE: MS. ANGELA MICHELLE ROHN MS CCCSLP

MEDICARE: MS. ANGELA MICHELLE ROHN MS CCCSLP
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
1235Z00000XSpeech-Language Pathologist146.006054IL

General Provider Information

NPI Number : 1770908865
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANGELA MICHELLE ROHN MS CCCSLP
Provider Business Mailing Address
First Line : 1030 ELISABETH DR
Second Line :
City : O FALLON
State : IL
Zip : 62269-3531
Country : US
Telephone Number : 618-589-9128
Fax Number :
Provider Business Practice Location Address
First Line : 105 W A ST
Second Line :
City : BELLEVILLE
State : IL
Zip : 62220-1326
Country : US
Telephone Number : 618-233-2830
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2014
Last Update Date : 02/26/2014

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