Provider Demographics
NPI:1326073842
Name:PHARR, ANGELA ELIZABETH (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:ELIZABETH
Last Name:PHARR
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:286 DEERFIELD FOREST PKWY
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-8453
Mailing Address - Country:US
Mailing Address - Phone:828-263-8871
Mailing Address - Fax:828-263-8898
Practice Address - Street 1:286 DEERFIELD FOREST PKWY
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-8453
Practice Address - Country:US
Practice Address - Phone:828-263-8871
Practice Address - Fax:828-263-8898
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC3513235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7467511Medicaid
NC0191TOtherBCBS PROVIDER NUMBER
NC129VROtherBCBS PROVIDER NUMBER
NC7401098Medicaid