Provider Demographics
NPI:1891344032
Name:STRATTON, ANGELA
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:STRATTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BRIAN CENTER
Mailing Address - Street 2:226 N OAKLAND AVE
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288
Mailing Address - Country:US
Mailing Address - Phone:336-623-1750
Mailing Address - Fax:
Practice Address - Street 1:226 N OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-3040
Practice Address - Country:US
Practice Address - Phone:336-623-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6976224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant