Provider Demographics
NPI:1356580377
Name:ANGELS TOUCH THERAPY LLC
Entity type:Organization
Organization Name:ANGELS TOUCH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JACALYN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:580-512-9881
Mailing Address - Street 1:1217 E CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73521-6405
Mailing Address - Country:US
Mailing Address - Phone:580-512-9881
Mailing Address - Fax:940-696-9957
Practice Address - Street 1:1217 E CHERRY ST
Practice Address - Street 2:
Practice Address - City:ALTUS
Practice Address - State:OK
Practice Address - Zip Code:73521-6405
Practice Address - Country:US
Practice Address - Phone:580-512-9881
Practice Address - Fax:940-696-9957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-14
Last Update Date:2009-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1466225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1780661959OtherNPI
OK200114950AMedicare UPIN