Provider Demographics
NPI:1205619459
Name:LEVY, ANGELIC MARIE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANGELIC
Middle Name:MARIE
Last Name:LEVY
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 1:18 PIERCE DR
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980-3700
Mailing Address - Country:US
Mailing Address - Phone:845-608-3297
Mailing Address - Fax:
Practice Address - Street 1:18 PIERCE DR
Practice Address - Street 2:
Practice Address - City:STONY POINT
Practice Address - State:NY
Practice Address - Zip Code:10980-3700
Practice Address - Country:US
Practice Address - Phone:845-608-3297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033371235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist