Provider Demographics
NPI:1003127531
Name:ADAMS, ANGELA KATHRYN (MA, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:KATHRYN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 508
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46061-0508
Mailing Address - Country:US
Mailing Address - Phone:317-774-3377
Mailing Address - Fax:317-774-3377
Practice Address - Street 1:18758 ROUND LAKE RD
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-1494
Practice Address - Country:US
Practice Address - Phone:317-774-3377
Practice Address - Fax:317-774-3377
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003445A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist