Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 1442 | WV |
NPI | 1376771238 |
---|---|
Provider Name | Mrs. Ashley Nicole Orndorff |
First Address | South Charleston, WV 25309-2304 |
Second Address | South Charleston, WV 25309-1841 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2009 |
Last Update Date | 31/07/2012 |