Provider Demographics
NPI:1659525350
Name:BOKELMANN, ANGELA H (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:H
Last Name:BOKELMANN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 41ST STREET CT W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-1370
Mailing Address - Country:US
Mailing Address - Phone:941-749-5167
Mailing Address - Fax:941-749-5167
Practice Address - Street 1:2204 41ST STREET CT W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-1370
Practice Address - Country:US
Practice Address - Phone:941-749-5167
Practice Address - Fax:941-749-5167
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA7156235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist