Angela Cavender, COTA

Individual provider Active NPI Occupational Therapy Assistant · Azle, TX

NPI 1679055263 · NPPES record last updated Aug 30, 2018

Key facts

NPI
1679055263
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
213032 (TX)
Practice address
721 Dunaway LN
Azle, TX 76020-2605
Phone
(321) 626-9610
NPI assigned
Aug 30, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
213032TXMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 213032 TX Yes

Addresses

Primary practice location

721 Dunaway LN
Azle, TX 76020-2605

Mailing address

2105 Remington St Apt 15C
Fort Worth, TX 76116-2163
Phone (321) 626-9610

Other identifiers

IdentifierTypeStateIssuer
213032OtherTXCOTA

Other providers in Azle, TX

All providers in Azle, TX · Occupational Therapy Assistant in Texas

Sources for this page

Verify at the official NPI Registry.