Provider Demographics
NPI:1861623035
Name:SODANO, ANGELA MARY (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARY
Last Name:SODANO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 SETON DR
Mailing Address - Street 2:
Mailing Address - City:ORWIGSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17961-1009
Mailing Address - Country:US
Mailing Address - Phone:570-366-1941
Mailing Address - Fax:570-366-7642
Practice Address - Street 1:1000 SETON DR
Practice Address - Street 2:
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961-1009
Practice Address - Country:US
Practice Address - Phone:570-366-1941
Practice Address - Fax:570-366-7642
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009547235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist