Provider Demographics
NPI:1982821401
Name:PAHOLSKI, ANGELA LANCIA (OT)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:LANCIA
Last Name:PAHOLSKI
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 WINDSWEPT RDG
Mailing Address - Street 2:
Mailing Address - City:IVORYTON
Mailing Address - State:CT
Mailing Address - Zip Code:06442-1233
Mailing Address - Country:US
Mailing Address - Phone:860-767-7569
Mailing Address - Fax:860-529-0126
Practice Address - Street 1:2162 SILAS DEANE HWY
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-2315
Practice Address - Country:US
Practice Address - Phone:860-513-1431
Practice Address - Fax:860-529-0126
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000580225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist