Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 0119001832 | VA |
NPI | 1073825774 |
---|---|
Provider Name | Mrs. Catherine Sharp Gilliam |
First Address | Henrico, VA 23231-8938 |
Second Address | Henrico, VA 23231-8938 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2010 |
Last Update Date | 10/07/2010 |