Provider Demographics
NPI:1568598696
Name:LANE, ANGELA STRAUCH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:STRAUCH
Last Name:LANE
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 1:16 TROJAN HORSE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:MD
Mailing Address - Zip Code:21131-1345
Mailing Address - Country:US
Mailing Address - Phone:443-286-1447
Mailing Address - Fax:
Practice Address - Street 1:952 RIDGEBROOK RD STE 1000
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:MD
Practice Address - Zip Code:21152-9471
Practice Address - Country:US
Practice Address - Phone:443-449-2580
Practice Address - Fax:301-663-8822
Is Sole Proprietor?:No
Enumeration Date:2007-02-25
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03227235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist