Provider Demographics
NPI:1578791869
Name:ANGEL CARE OCCUPATIONAL THERAPY CENTER
Entity Type:Organization
Organization Name:ANGEL CARE OCCUPATIONAL THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLEY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:978-521-6150
Mailing Address - Street 1:70 MERRIMACK ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6207
Mailing Address - Country:US
Mailing Address - Phone:978-521-6150
Mailing Address - Fax:978-521-2659
Practice Address - Street 1:70 MERRIMACK ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6207
Practice Address - Country:US
Practice Address - Phone:978-521-6150
Practice Address - Fax:978-521-2659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty