Provider Demographics
NPI:1831689157
Name:KOENIG, ANGELA M (AUD)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:M
Last Name:KOENIG
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 S BURNETT RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-2717
Mailing Address - Country:US
Mailing Address - Phone:937-325-8796
Mailing Address - Fax:937-325-6698
Practice Address - Street 1:435 S BURNETT RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-2717
Practice Address - Country:US
Practice Address - Phone:937-325-8796
Practice Address - Fax:937-325-6698
Is Sole Proprietor?:No
Enumeration Date:2018-05-11
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.021282355A2700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology Assistant