Provider Demographics
NPI:1861599060
Name:SIEH CERETTO, ANGELA RAE (MA, CCC-A, FAAA)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:RAE
Last Name:SIEH CERETTO
Suffix:
Gender:F
Credentials:MA, CCC-A, FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6809 S MINNESOTA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2570
Mailing Address - Country:US
Mailing Address - Phone:605-306-4481
Mailing Address - Fax:
Practice Address - Street 1:6809 S MINNESOTA AVE STE 101
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2570
Practice Address - Country:US
Practice Address - Phone:605-306-4481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00567231H00000X
MN7668231H00000X
MN2611237700000X
SD297A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist