Provider Demographics
NPI:1295033678
Name:BRATTON, ANGELA M (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:M
Last Name:BRATTON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MISS
Other - First Name:ANGELA
Other - Middle Name:M
Other - Last Name:AMTHOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSCCC-SLP
Mailing Address - Street 1:708 STRECK CT APT B
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-8613
Mailing Address - Country:US
Mailing Address - Phone:913-426-0604
Mailing Address - Fax:
Practice Address - Street 1:3333 W 10TH ST
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-2113
Practice Address - Country:US
Practice Address - Phone:660-826-2118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-08
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009007863235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist