Provider Demographics
NPI:1891446845
Name:PATEL, ANJLEE (SLP, EDM)
Entity Type:Individual
Prefix:
First Name:ANJLEE
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:SLP, EDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 E CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-2302
Mailing Address - Country:US
Mailing Address - Phone:408-375-4333
Mailing Address - Fax:
Practice Address - Street 1:840 E CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-2302
Practice Address - Country:US
Practice Address - Phone:408-375-4333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP17336235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist