Angela Marie Anklam, M.S.,CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · MC Lean, VA

NPI 1518446830 · NPPES record last updated Aug 8, 2018

Key facts

NPI
1518446830
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2202008950 (VA)
Practice address
1739 Kirby Rd
MC Lean, VA 22101-4817
Phone
(703) 536-4344
NPI assigned
Aug 8, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2202008950VAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202008950 VA Yes

Addresses

Primary practice location

1739 Kirby Rd
MC Lean, VA 22101-4817

Mailing address

604 Utterback Store Rd
Great Falls, VA 22066-3328
Phone (703) 626-4001

Other providers in MC Lean, VA

All providers in MC Lean, VA · Speech-Language Pathologist in Virginia

Sources for this page

Verify at the official NPI Registry.