Provider Demographics
NPI:1942330022
Name:ANGEL, DENISE BOLING (OTR)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:BOLING
Last Name:ANGEL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 SILVERLEAF DR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-7234
Mailing Address - Country:US
Mailing Address - Phone:859-240-2238
Mailing Address - Fax:859-402-8052
Practice Address - Street 1:832 SILVERLEAF DR
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-7234
Practice Address - Country:US
Practice Address - Phone:859-240-2238
Practice Address - Fax:859-402-8052
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-R1702225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist