Provider Demographics
NPI:1104941665
Name:NEAL, ANGELA JUNE (OT)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:JUNE
Last Name:NEAL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MRS
Other - First Name:ANGELA
Other - Middle Name:JUNE
Other - Last Name:HOWELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:1917 COTTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-5784
Mailing Address - Country:US
Mailing Address - Phone:803-648-9018
Mailing Address - Fax:
Practice Address - Street 1:1917 COTTONWOOD DR
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-5784
Practice Address - Country:US
Practice Address - Phone:803-648-9018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2762174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist