Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XP0200X | Occupational Therapist - Pediatrics | 0119005006 | VA |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 08968 | MD |
NPI | 1003067364 |
---|---|
Provider Name | Jill Stegall Schmidt |
First Address | Purcellville, VA 20132-7212 |
Second Address | Falls Church, VA 22044-2102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2008 |
Last Update Date | 07/11/2021 |