Provider Demographics
NPI:1407055460
Name:KAY, ANGELA MARIE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:KAY
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 1:4085 BROOK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MO
Mailing Address - Zip Code:63010-4845
Mailing Address - Country:US
Mailing Address - Phone:636-223-0440
Mailing Address - Fax:
Practice Address - Street 1:1108 CLARKE ST
Practice Address - Street 2:
Practice Address - City:DE SOTO
Practice Address - State:MO
Practice Address - Zip Code:63020-2706
Practice Address - Country:US
Practice Address - Phone:636-586-3022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO112124235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist