Angela Crabtree Gatlin, MS,CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Purvis, MS

NPI 1801089883 · NPPES record last updated Jun 18, 2014

Key facts

NPI
1801089883
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
S3175 (MS)
Practice address
8 Orange Orchard Dr
Purvis, MS 39475-4567
Phone
(601) 550-7270
NPI assigned
Aug 22, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
S3175MSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aultman Speech Therapy Services, LLC Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X S3175 MS Yes

Addresses

Primary practice location

8 Orange Orchard Dr
Purvis, MS 39475-4567

Mailing address

8 Orange Orchard Dr
Purvis, MS 39475-4567
Phone (601) 550-7270

Other providers in Purvis, MS

All providers in Purvis, MS · Speech-Language Pathologist in Mississippi

Sources for this page

Verify at the official NPI Registry.