Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 0119003336 | VA |
NPI | 1578878609 |
---|---|
Provider Name | Kara Rajana Jeffrey |
First Address | Woodstock, VA 22664 |
Second Address | Woodstock, VA 22664-1303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2010 |
Last Update Date | 12/08/2010 |