Doctor Name: | ANGELA PAOLA MAMMOLITO |
NPI Number: | 1346614864 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 242003695 |
Business Practice Address: | 13400 S Route 59 Suite 116-326 Plainfield, IL - 605855696 |
Business Phone Number: | 8152677334 |
Business Fax Number: | 6304299411 |
Mailing Address: | 13400 S Route 59, Suite 116-326 PLAINFIELD |
State: | IL |
Postal Code: | 605855696 |
Phone Number: | 8152677334 |
Fax Number: | 6304299411 |
NPI Enumeration Date: | 11/20/2015 |
NPI Last Update Date: | 11/20/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 242003695 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
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 |