Individual
MRS. ANGELA BEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1100 MERCER AVE, DECATUR, IN 46733-2303
(260) 724-2145
Mailing address
1712 DUART CT, NEW HAVEN, IN 46774-2214
(317) 460-5146
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004126A
IN
286500000X
Military Hospital
31004126A
IN
314000000X
Skilled Nursing Facility
31004126A
IN
Other
Enumeration date
03/23/2007
Last updated
04/25/2025
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