Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 0119004114 | VA |
NPI | 1275763179 |
---|---|
Provider Name | Ms. Ellen Kennelly Meekins |
First Address | Warrenton, VA 20186-3008 |
Second Address | Warrenton, VA 20186-3008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2009 |
Last Update Date | 27/07/2009 |