Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist |
NPI | 1003332354 |
---|---|
Provider Name | Katrina Kask |
First Address | Springfield, VA 22153 |
Second Address | Manassas, VA 20110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2017 |
Last Update Date | 18/08/2017 |