Provider Demographics
NPI:1578286696
Name:TATE, ANGELA ELYSABETH (CF)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:ELYSABETH
Last Name:TATE
Suffix:
Gender:F
Credentials:CF
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:ELYSABETH
Other - Last Name:SEXTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:310 CORPORATE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4638
Mailing Address - Country:US
Mailing Address - Phone:865-660-6574
Mailing Address - Fax:865-769-0801
Practice Address - Street 1:310 CORPORATE DR STE 101
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4638
Practice Address - Country:US
Practice Address - Phone:865-693-5622
Practice Address - Fax:865-769-0801
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8006235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist