Provider Demographics
NPI:1659886430
Name:ARNOLD, ANN
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:LANGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTL
Mailing Address - Street 1:1709 QUEEN PALM DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:FL
Mailing Address - Zip Code:32132-3211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:350 E INTERNATIONAL SPEEDWAY BLVD
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724-2402
Practice Address - Country:US
Practice Address - Phone:386-337-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-03
Last Update Date:2017-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT7569225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist