Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 001052 | VA |
NPI | 1245449875 |
---|---|
Provider Name | Beth Croghan |
First Address | Louisa, VA 23093-4921 |
Second Address | Fredericksburg, VA 22408-8606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 08/07/2007 |