Provider Demographics
NPI:1154468387
Name:TRIGUEROS, ANGELIQUE FRANCESCA (PHD, MS, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:ANGELIQUE
Middle Name:FRANCESCA
Last Name:TRIGUEROS
Suffix:
Gender:F
Credentials:PHD, MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1047 S OAK GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-0449
Mailing Address - Country:US
Mailing Address - Phone:417-818-6737
Mailing Address - Fax:
Practice Address - Street 1:1047 S OAK GROVE AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-0449
Practice Address - Country:US
Practice Address - Phone:417-818-6737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO116550235Z00000X
FL20329235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO460681505Medicaid