Provider Demographics
NPI:1841581170
Name:COLEMAN, ANGELA TAPP (MCD, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:TAPP
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MCD, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SILVER FOX CIR
Mailing Address - Street 2:
Mailing Address - City:HAUGHTON
Mailing Address - State:LA
Mailing Address - Zip Code:71037-7704
Mailing Address - Country:US
Mailing Address - Phone:318-949-9205
Mailing Address - Fax:
Practice Address - Street 1:200 SILVER FOX CIR
Practice Address - Street 2:
Practice Address - City:HAUGHTON
Practice Address - State:LA
Practice Address - Zip Code:71037-7704
Practice Address - Country:US
Practice Address - Phone:318-949-9205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3819235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist