Provider Demographics
NPI:1922081116
Name:AREL, MADELEINE THERESE (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MADELEINE
Middle Name:THERESE
Last Name:AREL
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:MADELEINE
Other - Middle Name:TERRY
Other - Last Name:AREL-DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:PO BOX 705
Mailing Address - Street 2:
Mailing Address - City:AVILA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93424-0705
Mailing Address - Country:US
Mailing Address - Phone:805-474-1543
Mailing Address - Fax:
Practice Address - Street 1:1130 GROVE ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401
Practice Address - Country:US
Practice Address - Phone:805-542-0830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT84225X00000X
CAOT0084225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWOT84AMedicare UPIN