Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 0131001057 | VA |
NPI | 1023369238 |
---|---|
Provider Name | Laura Bartlette |
First Address | Virginia Beach, VA 23452-5334 |
Second Address | Virginia Beach, VA 23452-5334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2012 |
Last Update Date | 27/09/2012 |