Provider Demographics
NPI:1225232135
Name:BRITT, ANGELA LEE (MS, OTR,L)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:LEE
Last Name:BRITT
Suffix:
Gender:F
Credentials:MS, OTR,L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 7TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-1822
Mailing Address - Country:US
Mailing Address - Phone:712-540-6050
Mailing Address - Fax:
Practice Address - Street 1:2121 W 19TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51103-2333
Practice Address - Country:US
Practice Address - Phone:712-233-3127
Practice Address - Fax:712-258-1177
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01800225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist