Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 0119004084 | VA |
NPI | 1003854381 |
---|---|
Provider Name | Judy D. Feingold |
First Address | Fairfax, VA 22030-4946 |
Second Address | Fairfax, VA 22030-4946 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 01/09/2016 |