Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT03082 | OH |
NPI | 1003820457 |
---|---|
Provider Name | Mrs. Angela Jeanne Knapp |
First Address | Bellefontaine, OH 43311 |
Second Address | Bellefontaine, OH 43311 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 05/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000201033 | ANTHEM (01) |