Individual
MRS. ANGELA LYNN PERKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
9800 45TH AVE N, APT. 111, PLYMOUTH, MN 55442-2657
(651) 387-6681
Mailing address
9800 45TH AVE N, APT. 111, PLYMOUTH, MN 55442-2657
(651) 387-6681
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8754
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12073055
ASHA#
—
01
—
8754
MINNESOTA LICENSE
MN
Enumeration date
06/20/2011
Last updated
06/20/2011
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