Angie Thomas Wade, SLP
Individual provider Active NPI Speech-Language Pathologist · Lagrange, KY
NPI 1578699583 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1578699583
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 1491 (KY)
- Practice address
- 2204 Courtney Dr
Lagrange, KY 40031-9129 - Phone
- (502) 222-0243
- Fax
- (502) 225-4907
- NPI assigned
- Feb 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1491 | KY | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1491 | KY | Yes |
Addresses
Primary practice location
2204 Courtney Dr
Lagrange, KY 40031-9129
Mailing address
2204 Courtney Dr
Lagrange, KY 40031-9129
Phone (502) 222-0243
Other providers in Lagrange, KY
- Robert Wilford Stone
- Therapeutic Interventions Therapy Services, PLLC
- Tamara Thomas
- Trilogy Healthcare of Lagrange, LLC
- Christopher Unkrich
- Christopher Byron White
- Kathy Wood
All providers in Lagrange, KY · Speech-Language Pathologist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.