Provider Demographics
NPI:1679178149
Name:ANGLERO VELEZ, KATHERINE (SLP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:ANGLERO VELEZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 CALLE LISBOA
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-1608
Mailing Address - Country:US
Mailing Address - Phone:787-560-5382
Mailing Address - Fax:
Practice Address - Street 1:EDIF. WILLIAM DAVILA CARR. #2 KM. 11.9 2DO PISO
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960
Practice Address - Country:US
Practice Address - Phone:787-798-8570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4256235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty