Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 0119004310 | VA |
NPI | 1295203248 |
---|---|
Provider Name | Donna C Gorman |
First Address | Virginia Beach, VA 23464-2370 |
Second Address | Virginia Beach, VA 23464-2370 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2018 |
Last Update Date | 07/11/2018 |