Provider Demographics
NPI:1598996407
Name:CALDWELL, ANGELA RENEE (MS, OTR/L, CLT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:RENEE
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:MS, OTR/L, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 BALDWIN ROAD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205
Mailing Address - Country:US
Mailing Address - Phone:412-922-8322
Mailing Address - Fax:
Practice Address - Street 1:2510 BALDWIN ROAD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205
Practice Address - Country:US
Practice Address - Phone:412-922-8322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT. 007045225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHOT 007045OtherOHIO OT LICENSURE
MD237809OtherNATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY