Provider Demographics
NPI:1205133063
Name:KERRIGAN, ANGELA LONADIER (CCC/SLP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:LONADIER
Last Name:KERRIGAN
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 MILLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3831
Mailing Address - Country:US
Mailing Address - Phone:972-803-4781
Mailing Address - Fax:
Practice Address - Street 1:10610 METRIC DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-5581
Practice Address - Country:US
Practice Address - Phone:214-221-4405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106382235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist