MEDICARE: MRS. ANGELA NICOLE SANCHEZ OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	R5804	KY
2	225X00000X	Occupational Therapist	134113	KY

General Provider Information

NPI Number	:	1760754998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELA NICOLE SANCHEZ OTR/L

Provider Business Mailing Address
First Line	:	724 HARVARD DR
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42301-6152
Country	:	US
Telephone Number	:	270-240-5051
Fax Number	:

Provider Business Practice Location Address
First Line	:	724 HARVARD DR
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42301-6152
Country	:	US
Telephone Number	:	270-240-5051
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2012
Last Update Date	:	09/20/2023

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