Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 0119004421 | VA |
NPI | 1114137981 |
---|---|
Provider Name | Ms. Amy Anderson Siegel |
First Address | Stafford, VA 22554-1532 |
Second Address | Stafford, VA 22554 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 13/08/2018 |