Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 0119-008149 | VA |
NPI | 1245686062 |
---|---|
Provider Name | Mrs. Jane Elwood |
First Address | Winchester, VA 22601-6900 |
Second Address | Winchester, VA 22601-2872 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2016 |
Last Update Date | 23/01/2020 |