Basic Information
| Provider Information | |||||||||
| NPI: | 1720338635 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANGLIN | ||||||||
| FirstName: | APRIL | ||||||||
| MiddleName: | DAPHNE | ||||||||
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| Credential: | OT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1220 N. SHORE PARKWAY | ||||||||
| Address2: | SUITE B | ||||||||
| City: | BRANDON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 39047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6018290505 | ||||||||
| FaxNumber: | 6018290506 | ||||||||
| Practice Location | |||||||||
| Address1: | 7213 S SIWELL RD | ||||||||
| Address2: | |||||||||
| City: | BYRAM | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392729776 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6013469191 | ||||||||
| FaxNumber: | 6013465011 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/18/2012 | ||||||||
| LastUpdateDate: | 09/18/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OT2496 | MS | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.