Provider Demographics
NPI:1104997048
Name:STAMEY, ANGELA C (OTRL)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:C
Last Name:STAMEY
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 BUTTERFLY LN
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:GA
Mailing Address - Zip Code:30143-4671
Mailing Address - Country:US
Mailing Address - Phone:770-364-8182
Mailing Address - Fax:706-337-2967
Practice Address - Street 1:50 BUTTERFLY LN
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:GA
Practice Address - Zip Code:30143-4671
Practice Address - Country:US
Practice Address - Phone:770-364-8182
Practice Address - Fax:706-337-2967
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT002159225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics