Provider Demographics
NPI:1841961000
Name:ZUEHLKE, ANGELA ANN
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:ANN
Last Name:ZUEHLKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 KEY AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:TX
Mailing Address - Zip Code:76634-1035
Mailing Address - Country:US
Mailing Address - Phone:254-675-1888
Mailing Address - Fax:
Practice Address - Street 1:1102 KEY AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:TX
Practice Address - Zip Code:76634-1035
Practice Address - Country:US
Practice Address - Phone:254-675-1888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106182235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist