Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 0131000455 | VA |
NPI | 1023307980 |
---|---|
Provider Name | Elaine Jones |
First Address | Richmond, VA 23227-4622 |
Second Address | Richmond, VA 23227-4622 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2011 |
Last Update Date | 31/03/2011 |