Provider Demographics
NPI:1467656132
Name:REIMER, ANGELA D (OTD, OTR)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:D
Last Name:REIMER
Suffix:
Gender:F
Credentials:OTD, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2836 W STATE ROAD 114
Mailing Address - Street 2:
Mailing Address - City:SOUTH WHITLEY
Mailing Address - State:IN
Mailing Address - Zip Code:46787-9750
Mailing Address - Country:US
Mailing Address - Phone:260-229-2349
Mailing Address - Fax:
Practice Address - Street 1:7956 W JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-4140
Practice Address - Country:US
Practice Address - Phone:260-435-6143
Practice Address - Fax:574-223-4172
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31005373A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist