Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics |
NPI | 1043986946 |
---|---|
Provider Name | Isabella Zornes |
First Address | Roanoke, VA 24011-2024 |
Second Address | Daleville, VA 24083-3205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2021 |
Last Update Date | 19/08/2021 |