Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 0119008255 | VA |
NPI | 1033703327 |
---|---|
Provider Name | Christian Taylor Stallings |
First Address | Mechanicsville, VA 23111-5243 |
Second Address | Glen Allen, VA 23060-3330 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2021 |
Last Update Date | 26/02/2021 |