Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 0119007025 | VA |
N | 225X00000X | Occupational Therapist | 07346 | MD |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 07346 | MD |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 07346 | MD |
N | 225XP0200X | Occupational Therapist - Pediatrics | 07346 | MD |
NPI | 1003233628 |
---|---|
Provider Name | Mrs. Melissa Ann Stapleford |
First Address | Virginia Beach, VA 23455-6423 |
Second Address | Virginia Beach, VA 23464-4128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2014 |
Last Update Date | 02/08/2016 |