Individual
ANGELA JO THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
14736 LIBERTY CHURCH ST SE, MINERVA, OH 44657-8715
(330) 868-9845
Mailing address
14736 LIBERTY CHURCH ST SE, MINERVA, OH 44657-8715
(330) 868-9845
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
01931
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TTCAN1417490
ANTHEM PPO
OH
Enumeration date
03/26/2007
Last updated
07/08/2007
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