Provider Demographics
NPI:1659334027
Name:PAGE, ANGELA B (AUD CCC-A)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:B
Last Name:PAGE
Suffix:
Gender:F
Credentials:AUD CCC-A
Other - Prefix:DR
Other - First Name:ANGELA
Other - Middle Name:M
Other - Last Name:BARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:114 WOODLAND ST
Mailing Address - Street 2:DEPARTMENT OF REHAB.
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-1299
Mailing Address - Country:US
Mailing Address - Phone:860-714-5600
Mailing Address - Fax:860-714-8104
Practice Address - Street 1:114 WOODLAND ST
Practice Address - Street 2:DEPARTMENT OF REHAB.
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-1299
Practice Address - Country:US
Practice Address - Phone:860-714-5600
Practice Address - Fax:860-714-8104
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT511231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist