Provider Demographics
NPI:1568694768
Name:HOSMAN, ANGELA RAY
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:RAY
Last Name:HOSMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANGIE
Other - Middle Name:
Other - Last Name:HOSMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:COTA
Mailing Address - Street 1:130 UNDERHILL RD
Mailing Address - Street 2:
Mailing Address - City:BEEBE
Mailing Address - State:AR
Mailing Address - Zip Code:72012-9751
Mailing Address - Country:US
Mailing Address - Phone:501-230-3100
Mailing Address - Fax:
Practice Address - Street 1:130 UNDERHILL RD
Practice Address - Street 2:
Practice Address - City:BEEBE
Practice Address - State:AR
Practice Address - Zip Code:72012-9751
Practice Address - Country:US
Practice Address - Phone:501-230-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A570224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant