Provider Demographics
NPI:1861682536
Name:LADEAU, ANGELA SUE (OTR)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:SUE
Last Name:LADEAU
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2158 COUNTY ROAD 95
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:CO
Mailing Address - Zip Code:81226-9513
Mailing Address - Country:US
Mailing Address - Phone:719-431-0115
Mailing Address - Fax:
Practice Address - Street 1:903 MOORE DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:CO
Practice Address - Zip Code:81226-9509
Practice Address - Country:US
Practice Address - Phone:719-431-0115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1004389225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist