Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2306603771 | VA |
NPI | 1013410729 |
---|---|
Provider Name | Jama Le Ann Littmann |
First Address | Fairfax, VA 22030-4567 |
Second Address | Woodbridge, VA 22191-2806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2018 |
Last Update Date | 09/03/2018 |