Provider Demographics
NPI:1073542395
Name:BARTON, ANGELA KAY
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:KAY
Last Name:BARTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:KAY
Other - Last Name:MOEGGENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:330 BARCLAY AVE NE
Mailing Address - Street 2:SUITE GL1
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2556
Mailing Address - Country:US
Mailing Address - Phone:616-459-2424
Mailing Address - Fax:616-459-5733
Practice Address - Street 1:330 BARCLAY AVE NE
Practice Address - Street 2:SUITE GL1
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2556
Practice Address - Country:US
Practice Address - Phone:616-459-2424
Practice Address - Fax:616-459-5733
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501002458231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist