Provider Demographics
NPI:1467599647
Name:ENGEL, ALIDA (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ALIDA
Middle Name:
Last Name:ENGEL
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 EDGEWOOD AVE
Mailing Address - Street 2:CENTER FOR SPEECH AND LEARNING
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-2216
Mailing Address - Country:US
Mailing Address - Phone:203-397-3224
Mailing Address - Fax:
Practice Address - Street 1:801 EDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-2216
Practice Address - Country:US
Practice Address - Phone:203-397-3224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000413235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist