Provider Demographics
NPI:1275650277
Name:HALLAUER, ANGEL ANN (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANGEL
Middle Name:ANN
Last Name:HALLAUER
Suffix:
Gender:F
Credentials: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 1:1302 TIMBERLAND DR
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956-9053
Mailing Address - Country:US
Mailing Address - Phone:479-474-3346
Mailing Address - Fax:479-474-5543
Practice Address - Street 1:4401 YORKSHIRE DR
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72904-5713
Practice Address - Country:US
Practice Address - Phone:479-785-5484
Practice Address - Fax:479-783-7675
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1254235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist