MRS. Angela Joan Shupak, COTA

NPI #1669679452 in Kilgore, Texas

Provider Information

NPI Number: 1669679452
Entity Type: Individual
Name: MRS. Angela Joan Shupak, COTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Occupational Therapist
Credential: COTA
Enumeration Date: Jun 27, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1901 WHIPPORWILL LN
City: Kilgore
State: Texas
ZIP Code: 75662-3880
Phone: (903) 984-6264

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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