Provider Demographics
NPI:1275798647
Name:STARLINE, ANGIE EVANS
Entity Type:Individual
Prefix:
First Name:ANGIE
Middle Name:EVANS
Last Name:STARLINE
Suffix:
Gender:F
Credentials:
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 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 HOSPITAL DR STE 360
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2867
Practice Address - Country:US
Practice Address - Phone:740-566-4660
Practice Address - Fax:740-566-4661
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVA-0238231H00000X
OHA-01543231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist