Provider Demographics
NPI:1407135668
Name:MISTER, ANGELA (AUD, CCC-A)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MISTER
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:DICKINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5869
Mailing Address - Street 2:
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-5869
Mailing Address - Country:US
Mailing Address - Phone:670-256-3256
Mailing Address - Fax:
Practice Address - Street 1:HINEMLO DR.
Practice Address - Street 2:COMMONWEALTH HEALTH CENTER
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950
Practice Address - Country:US
Practice Address - Phone:670-256-3256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist