Provider Demographics
NPI:1841550100
Name:DIETSCH, ANGELA M (PHD, L/CCC-SLP)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:M
Last Name:DIETSCH
Suffix:
Gender:F
Credentials:PHD, L/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4075 E CAMPUS LOOP S
Mailing Address - Street 2:BKC 101W
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68583-1530
Mailing Address - Country:US
Mailing Address - Phone:402-472-0932
Mailing Address - Fax:
Practice Address - Street 1:4075 E CAMPUS LOOP S
Practice Address - Street 2:BARKLEY CLINIC
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68583-1530
Practice Address - Country:US
Practice Address - Phone:402-472-2071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1488235Z00000X
KS2752235Z00000X
MO112137235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist