Provider Demographics
NPI:1871133983
Name:TEXTOR, ANGELA LYNN (AT)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:LYNN
Last Name:TEXTOR
Suffix:
Gender:F
Credentials:AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 N DEPEYSTER ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-2514
Mailing Address - Country:US
Mailing Address - Phone:330-676-8700
Mailing Address - Fax:
Practice Address - Street 1:1400 N MANTUA ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-2334
Practice Address - Country:US
Practice Address - Phone:330-676-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0008282255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer