Provider Demographics
NPI:1386815280
Name:FYFFE, ANGELA R (AUD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:R
Last Name:FYFFE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MRS
Other - First Name:ANGELA
Other - Middle Name:R
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:8424 CLINT DRIVE
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012
Mailing Address - Country:US
Mailing Address - Phone:816-322-8883
Mailing Address - Fax:816-322-8889
Practice Address - Street 1:8424 CLINT DRIVE
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012
Practice Address - Country:US
Practice Address - Phone:816-322-8883
Practice Address - Fax:816-322-8889
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1396231H00000X
MO111863231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist