Individual
MS. ANGIE CEELOK CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
388 PERKINS MADDEN RD, HINDMAN, KY 41822-9003
(606) 785-5011
Mailing address
307 INTERNATIONAL CIR STE 100, HUNT VALLEY, MD 21030-1387
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
246561
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14036706
AMERICAN SPEECH-HEARING-LANGUAGE ASSOCIATION
—
01
—
246561
STATE LICENSE
KY
01
—
SP.11058
STATE LICENSE
OH
Enumeration date
04/12/2019
Last updated
04/12/2019
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