Individual
MS. ANGELA GAIL TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCD/CCC-SLP
Contact information
Practice address
3400 MCCLURE BRIDGE RD G 701, DULUTH, GA 30096-8751
(678) 957-1012
(678) 957-1013
Mailing address
3400 MCCLURE BRIDGE RD G 701, DULUTH, GA 30096-8751
(678) 957-1012
(678) 957-1013
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
006491
GA
235Z00000X
Speech-Language Pathologist
SLP 5334
AZ
235Z00000X
Speech-Language Pathologist
Primary
SLP006491
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
169808036D
—
GA
Enumeration date
04/09/2007
Last updated
06/17/2016
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