Provider Demographics
NPI:1477799187
Name:ARGUETA, ANGELA JENNY
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:JENNY
Last Name:ARGUETA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6506 LOISDALE RD STE 302
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-1800
Mailing Address - Country:US
Mailing Address - Phone:703-924-4100
Mailing Address - Fax:703-922-5048
Practice Address - Street 1:6506 LOISDALE RD STE 302
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-1800
Practice Address - Country:US
Practice Address - Phone:703-924-4100
Practice Address - Fax:703-922-5048
Is Sole Proprietor?:No
Enumeration Date:2008-12-30
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202007472235Z00000X
VA0133000558103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst