Individual
ANGELA IMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
8039 LINE AVE STE 1B, SHREVEPORT, LA 71106-5145
(318) 861-1965
Mailing address
3468 BEVERLY PL, SHREVEPORT, LA 71105-2022
(318) 517-4948
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
303345
LA
Other
Enumeration date
10/30/2020
Last updated
10/30/2020
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