Individual
ANGELA R SHEHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
917 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1443
(765) 463-2200
(765) 463-3625
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 449-2732
(765) 449-1196
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31003006A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000961346
ANTHEM PROVIDER NUMBER
IN
05
—
200935630
—
IN
Enumeration date
10/16/2006
Last updated
10/19/2016
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