Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics |
NPI | 1023781069 |
---|---|
Provider Name | Jordan Renee Schmidt |
First Address | Fredericksburg, VA 22401-3177 |
Second Address | Fredericksburg, VA 22401-3177 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2021 |
Last Update Date | 27/07/2021 |