Provider Demographics
NPI:1710112149
Name:ADAIR, ANGELA K (SLP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:K
Last Name:ADAIR
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 1:122 E VERNA JEAN DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH PADRE ISLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78578
Mailing Address - Country:US
Mailing Address - Phone:956-943-2248
Mailing Address - Fax:
Practice Address - Street 1:225 MESQUITE DR
Practice Address - Street 2:
Practice Address - City:LAGUNA VISTA
Practice Address - State:TX
Practice Address - Zip Code:78578
Practice Address - Country:US
Practice Address - Phone:956-607-8329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1041232355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant