Provider Demographics
NPI:1962386706
Name:CARON, ANGELINA MARIE (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:ANGELINA
Middle Name:MARIE
Last Name:CARON
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4810 28TH AVE S UNIT 323
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-9174
Mailing Address - Country:US
Mailing Address - Phone:320-304-9485
Mailing Address - Fax:
Practice Address - Street 1:4575 23RD AVE S STE 400
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8783
Practice Address - Country:US
Practice Address - Phone:701-347-1782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN107875225X00000X
ND2227225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist