Provider Demographics
NPI:1316210222
Name:PIAZZA, ANGELA VERONICA (MS ED CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:VERONICA
Last Name:PIAZZA
Suffix:
Gender:F
Credentials:MS ED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 FIDDLERS LN
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-5343
Mailing Address - Country:US
Mailing Address - Phone:518-785-8591
Mailing Address - Fax:
Practice Address - Street 1:30 SOUTHGATE RD
Practice Address - Street 2:
Practice Address - City:LOUDONVILLE
Practice Address - State:NY
Practice Address - Zip Code:12211-1132
Practice Address - Country:US
Practice Address - Phone:518-785-6607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017584235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist