Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 0119003742 | VA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 0119003742 | VA |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 0119003742 | VA |
NPI | 1285851568 |
---|---|
Provider Name | Mr. Joshua Matthew Adler |
First Address | Virginia Beach, VA 23462-5631 |
Second Address | Virginia Beach, VA 23462-5631 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 17/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1851770598 | (05) | VA |