Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 0119000098 | VA |
NPI | 1295268720 |
---|---|
Provider Name | Beth Cole |
First Address | Mechanicsville, VA 23116-1844 |
Second Address | Mechanicsville, VA 23116-1844 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2017 |
Last Update Date | 11/04/2017 |