Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 0119001308 | VA |
NPI | 1174509830 |
---|---|
Provider Name | Julie A Brody |
First Address | Fairfax, VA 22030-6078 |
Second Address | Alexandria, VA 22310-2510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2005 |
Last Update Date | 28/01/2014 |