Basic Information
| Provider Information | |||||||||
| NPI: | 1356515480 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARTER | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | NIX | ||||||||
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| Credential: | M.S.,CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 405 LONDONDERRY DR | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | WACO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 767127924 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2547767744 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3115 PINE AVE | ||||||||
| Address2: | 808 | ||||||||
| City: | WACO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 767083247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2547530351 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2008 | ||||||||
| LastUpdateDate: | 04/18/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 10923 | TX | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.