Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 0119000785 | VA |
NPI | 1033611462 |
---|---|
Provider Name | Ellen Robin Schwartzberg |
First Address | Norfolk, VA 23518-1024 |
Second Address | Norfolk, VA 23503-3944 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2018 |
Last Update Date | 01/03/2018 |