Provider Demographics
NPI:1467962324
Name:WARD, ADRIENNE ANGELOPOULOS (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:ANGELOPOULOS
Last Name:WARD
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 1:449 MULBERRY LN
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:VA
Mailing Address - Zip Code:24273-4908
Mailing Address - Country:US
Mailing Address - Phone:423-341-8021
Mailing Address - Fax:
Practice Address - Street 1:332 SCHOOLHOUSE HILL DR NE
Practice Address - Street 2:
Practice Address - City:COEBURN
Practice Address - State:VA
Practice Address - Zip Code:24230-4013
Practice Address - Country:US
Practice Address - Phone:276-395-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202006806235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist