Provider Demographics
NPI:1619133675
Name:YERMAN, ANZHELA (SLP)
Entity Type:Individual
Prefix:
First Name:ANZHELA
Middle Name:
Last Name:YERMAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:ANZHELA
Other - Middle Name:
Other - Last Name:POLUNENKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:40 EQUESTRIAN DR.
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016
Mailing Address - Country:US
Mailing Address - Phone:919-271-1181
Mailing Address - Fax:
Practice Address - Street 1:2500 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-4314
Practice Address - Country:US
Practice Address - Phone:336-375-2240
Practice Address - Fax:336-375-2214
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist