Doctor Name: | ANGELA ELENI KIOULTZOPOULOS |
NPI Number: | 1215224357 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | |
Business Practice Address: | 7a Ginger Creek Village Dr. Glen Carbon, IL - 62034 |
Business Phone Number: | 6186567157 |
Business Fax Number: | 6186560266 |
Mailing Address: | 5331 Richland Woods Dr, ALTON |
State: | IL |
Postal Code: | 620026970 |
Phone Number: | 2604384127 |
Fax Number: | |
NPI Enumeration Date: | 07/08/2011 |
NPI Last Update Date: | 07/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |