Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 0119002028 | VA |
Y | 225XH1200X | Occupational Therapist - Hand | 0119002028 | VA |
N | 2251H1300X | Human Factors | 0119002028 | VA |
N | 225XH1300X | Human Factors | 0119002028 | VA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 0119002028 | VA |
N | 225XP0200X | Occupational Therapist - Pediatrics | 0119002028 | VA |
N | 226300000X | Kinesiotherapist | 0119002028 | VA |
NPI | 1184686453 |
---|---|
Provider Name | Mrs. Phyllis R Ross |
First Address | Yorktown, VA 23693-2780 |
Second Address | Newport News, VA 23606-4406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2006 |
Last Update Date | 09/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
008948721 | (05) | VA |
2062541 | MAIL HANDLERS BENIFITS (01) | VA |
2101706 | ALLIANCE PPO (01) | VA |
2101706 | MAMSI / GEHA (01) | VA |
462361 | ANTHEM BC/BS (01) | VA |
70510 | VETRI SYSTEMS (01) | VA |
7202455 | AETNA (01) | VA |
P00204753 | MEDICARE RAILROAD (01) | VA |