Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 0119004441 | VA |
NPI | 1003242157 |
---|---|
Provider Name | Mrs. Jennifer Danielle Papenfuse |
First Address | Roanoke, VA 24019-2722 |
Second Address | Roanoke, VA 24019-2722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2013 |
Last Update Date | 20/09/2013 |