Provider Demographics
NPI:1932536992
Name:WINSLOW, ANGELA (OTR)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:WINSLOW
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 1:28862 VIA DE LUNA
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-7601
Mailing Address - Country:US
Mailing Address - Phone:951-204-1348
Mailing Address - Fax:
Practice Address - Street 1:28862 VIA DE LUNA
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-7601
Practice Address - Country:US
Practice Address - Phone:951-204-1348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1452225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist