Individual
MRS. ANGELA IRENE VANCLEVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
100 E. HIGHLAND DRIVE, OCONTO FALLS, WI 54154
(920) 848-3272
Mailing address
7517 W COLD SPRING RD, GREENFIELD, WI 53220-2814
(414) 327-6603
(414) 327-5411
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2024-027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11014100
—
WI
05
—
11014110
—
WI
01
—
390848401050
BLUE CROSS
WI
Enumeration date
04/14/2008
Last updated
07/11/2016
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