Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 0119008757 | VA |
NPI | 1023602976 |
---|---|
Provider Name | Amy Gail Duran |
First Address | North Chesterfield, VA 23235-3918 |
Second Address | Richmond, VA 23233-7632 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2021 |
Last Update Date | 22/02/2021 |