Provider Demographics
NPI:1699073650
Name:ANGALET, MARY SAWYER (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:SAWYER
Last Name:ANGALET
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 BRIARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-4700
Mailing Address - Country:US
Mailing Address - Phone:864-907-0223
Mailing Address - Fax:
Practice Address - Street 1:108 BRIARWOOD DR
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-4700
Practice Address - Country:US
Practice Address - Phone:864-907-0223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC747225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist