Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 0119002324 | VA |
NPI | 1215090980 |
---|---|
Provider Name | Mrs. Angela Marie Fitzgerald |
First Address | Newport News, VA 23606-4425 |
Second Address | Newport News, VA 23606-4425 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2006 |
Last Update Date | 09/10/2008 |