Angela G Anderson, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

9479977-4102 Issued in UT

Practice address

6410 Old Main HL
Logan, UT 84322-6410

Phone

(435) 797-1346

NPI assigned

Feb 15, 2019

Last updated

Feb 15, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1922564897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 OLD MAIN HL",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843226410",
            "telephone_number": "435-797-1346",
            "fax_number": "844-308-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 OLD MAIN HL",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843226410",
            "telephone_number": "435-797-1346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ANGELA",
        "middle_name": "G",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-15",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "UT",
            "license": "9479977-4102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay P Andersen, OTR/L
• Megan Lynn Andersen, CSW, CTRS
• Allan David Anderson, MD
• Amelia S. Anderson, MD
• Andrew Justin Anderson, LMT, PTA
• Cody Sue Anderson, RN
• Cole Wood Anderson
• David Austin Anderson, MD
• Drew Anderson, OCCUPATIONAL THERAPY
• Gregory Earl Anderson, DDS

• Speech-Language Pathologist in Logan, UT
• Providers in Logan, UT by specialty
• Speech-Language Pathologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.