Provider Demographics
NPI:1730356171
Name:ABDON, ANGELA GWEN (MS, OTR/L)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:GWEN
Last Name:ABDON
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 STIRRUP RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244-3918
Mailing Address - Country:US
Mailing Address - Phone:859-699-2722
Mailing Address - Fax:
Practice Address - Street 1:6101 STIRRUP RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-3918
Practice Address - Country:US
Practice Address - Phone:859-699-2722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004470A225X00000X
OHOT007421225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist