Provider Demographics
NPI:1629281399
Name:DE ANGELIS, GRACIELA CRISTINA (MED, CCC-A)
Entity Type:Individual
Prefix:
First Name:GRACIELA
Middle Name:CRISTINA
Last Name:DE ANGELIS
Suffix:
Gender:F
Credentials:MED, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DUMC 3887 CLINIC 1-I 40 DUKE MEDICINE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-684-3859
Mailing Address - Fax:919-668-2741
Practice Address - Street 1:40 DUKE MEDICINE CIR # 1-I
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-684-3859
Practice Address - Fax:919-668-2741
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3221231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist