Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 0119008943 | VA |
NPI | 1003498445 |
---|---|
Provider Name | Mckenna Weeks |
First Address | Amelia Court House, VA 23002-2866 |
Second Address | Fort Belvoir, VA 22060-2703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2021 |
Last Update Date | 26/04/2021 |