Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology |
NPI | 1497328611 |
---|---|
Provider Name | Joshua Wenig |
First Address | Winchester, VA 22603-4125 |
Second Address | Leesburg, VA 20176-3687 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2021 |
Last Update Date | 24/07/2021 |