Provider Demographics
NPI:1649522020
Name:FRIER, ANGELA NICHOLE (COTA)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:NICHOLE
Last Name:FRIER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 POPLAR DR
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:IN
Mailing Address - Zip Code:47960-1670
Mailing Address - Country:US
Mailing Address - Phone:574-297-5540
Mailing Address - Fax:
Practice Address - Street 1:814 S 6TH ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:IN
Practice Address - Zip Code:47960-8199
Practice Address - Country:US
Practice Address - Phone:574-583-0324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32002044A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant