Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 0119004727 | VA |
N | 225X00000X | Occupational Therapist | OT11716 | FL |
N | 225XE0001X | Environmental Modification | 0119004727 | VA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 0119004727 | VA |
N | 225XP0200X | Occupational Therapist - Pediatrics | 0119004727 | VA |
NPI | 1013342997 |
---|---|
Provider Name | Dr. Darnelle Mason |
First Address | Triangle, VA 22172-0515 |
Second Address | Dumfries, VA 22025-1518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2013 |
Last Update Date | 10/09/2013 |