Individual
ANGELA WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
142 STUART NELSON PARK RD, PADUCAH, KY 42001-9678
(270) 442-9502
Mailing address
3728 UPPER SALEM RD, METROPOLIS, IL 62960-3091
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
134992
KY
Other
Enumeration date
02/29/2016
Last updated
06/23/2017
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