Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 13746 | MA |
N | 225X00000X | Occupational Therapist | 4321 | CT |
Y | 225XH1200X | Occupational Therapist - Hand | 0119009259 | VA |
NPI | 1174928535 |
---|---|
Provider Name | Alexander Degann |
First Address | North Chesterfield, VA 23225-4067 |
Second Address | Mc Lean, VA 22102-4330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2014 |
Last Update Date | 08/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13746 | (05) | MA |