Individual
ANGELIQUE BERNAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
8101 WILLOW BRANCH DR, WAXHAW, NC 28173-7039
(704) 577-1951
Mailing address
8101 WILLOW BRANCH DR, WAXHAW, NC 28173-7039
(704) 577-1951
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891248100
—
NC
Enumeration date
08/03/2016
Last updated
10/06/2021
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