Individual
ANGELINA COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1160 KEPLER DR, GREEN BAY, WI 54311-8321
(920) 288-5400
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8590-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100267368
—
WI
Enumeration date
02/09/2024
Last updated
04/26/2024
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