Provider Demographics
NPI:1558113563
Name:HILL ROEBUCK, ANGELIQUE ANTOINAE (OTD)
Entity Type:Individual
Prefix:DR
First Name:ANGELIQUE
Middle Name:ANTOINAE
Last Name:HILL ROEBUCK
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 S QUANTOCK ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80018-1802
Mailing Address - Country:US
Mailing Address - Phone:714-878-4515
Mailing Address - Fax:
Practice Address - Street 1:61 S QUANTOCK ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80018-1802
Practice Address - Country:US
Practice Address - Phone:714-878-4515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0008407225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist