Provider Demographics
NPI:1861158313
Name:MURPH, ANGELA (COTA/L)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MURPH
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 SPILLBURG CT
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-8949
Mailing Address - Country:US
Mailing Address - Phone:843-250-2499
Mailing Address - Fax:
Practice Address - Street 1:1206 N FULTON ST
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-1926
Practice Address - Country:US
Practice Address - Phone:910-875-4280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant