Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 0119005509 | VA |
NPI | 1124324389 |
---|---|
Provider Name | Chelsea Ann Liller |
First Address | Morgantown, WV 26505-1858 |
Second Address | Roanoke, VA 24015-3829 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2011 |
Last Update Date | 10/12/2019 |