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NPI Code Detail

MEDICARE: MRS. ANGELA LEE LATIOLAIS OTR

MEDICARE:  MRS. ANGELA LEE LATIOLAIS  OTR
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
1225X00000XOccupational Therapist31003588AIN

General Provider Information

NPI Number : 1861618266
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANGELA LEE LATIOLAIS OTR
Provider Business Mailing Address
First Line : 7696 MOUNT ZION RD
Second Line :
City : BLOOMINGTON
State : IN
Zip : 47403-9457
Country : US
Telephone Number : 812-330-4375
Fax Number :
Provider Business Practice Location Address
First Line : 14901 CAREY RD
Second Line :
City : CARMEL
State : IN
Zip : 46033-6000
Country : US
Telephone Number : 877-407-3422
Fax Number : 877-407-4329
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2007
Last Update Date : 04/21/2025

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Directions to “ MRS. ANGELA LEE LATIOLAIS OTR” Practice Location

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