Provider Demographics
NPI:1285321927
Name:OEN, ANGELA M
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:OEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3580 SIMON RD
Mailing Address - Street 2:
Mailing Address - City:RUSSIA
Mailing Address - State:OH
Mailing Address - Zip Code:45363-9672
Mailing Address - Country:US
Mailing Address - Phone:937-638-6674
Mailing Address - Fax:
Practice Address - Street 1:3580 SIMON RD
Practice Address - Street 2:
Practice Address - City:RUSSIA
Practice Address - State:OH
Practice Address - Zip Code:45363-9672
Practice Address - Country:US
Practice Address - Phone:937-638-6674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services