Provider Demographics
NPI:1396286795
Name:EAGLESTON, ANGELA T (MS OTR/L)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:T
Last Name:EAGLESTON
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 1:398 HAVERHILL ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-1324
Mailing Address - Country:US
Mailing Address - Phone:617-875-9679
Mailing Address - Fax:855-232-8604
Practice Address - Street 1:398 HAVERHILL ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-1324
Practice Address - Country:US
Practice Address - Phone:617-875-9679
Practice Address - Fax:855-232-8604
Is Sole Proprietor?:No
Enumeration Date:2017-03-17
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA539768225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist