Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 0119000329 | VA |
NPI | 1083615306 |
---|---|
Provider Name | Gretchen L Maurer |
First Address | Norfolk, VA 23510-1405 |
Second Address | Norfolk, VA 23510-1405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 20/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
670000006 | (02) |