Provider Demographics
NPI:1508902768
Name:KOKES, ANGELA MARTINA (OTR-L)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARTINA
Last Name:KOKES
Suffix:
Gender:F
Credentials:OTR-L
Other - Prefix:
Other - First Name:MARTY
Other - Middle Name:
Other - Last Name:KOKES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR-L
Mailing Address - Street 1:2505 NEBLETT AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216-4949
Mailing Address - Country:US
Mailing Address - Phone:502-449-1278
Mailing Address - Fax:
Practice Address - Street 1:982 EASTERN PKWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1566
Practice Address - Country:US
Practice Address - Phone:502-595-4459
Practice Address - Fax:502-595-3403
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYRO432225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics