Provider Demographics
NPI:1043693476
Name:GUNTER, ANGELA
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:
Last Name:GUNTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1089 TWO BID RD
Mailing Address - Street 2:
Mailing Address - City:EVINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24550-2484
Mailing Address - Country:US
Mailing Address - Phone:434-251-3540
Mailing Address - Fax:
Practice Address - Street 1:1089 TWO BID RD
Practice Address - Street 2:
Practice Address - City:EVINGTON
Practice Address - State:VA
Practice Address - Zip Code:24550-2484
Practice Address - Country:US
Practice Address - Phone:434-251-3540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131001132224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant