Provider Demographics
NPI:1043316813
Name:HILL, ANGELA (OTR)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:HILL
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:W5572 COUNTY ROAD CW UNIT 14A
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53098-4576
Mailing Address - Country:US
Mailing Address - Phone:920-299-6207
Mailing Address - Fax:
Practice Address - Street 1:W5572 COUNTY ROAD CW UNIT 14A
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:WI
Practice Address - Zip Code:53098-4576
Practice Address - Country:US
Practice Address - Phone:920-299-6207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5901-026225X00000X
WI5901-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist