Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 0119000869 | VA |
NPI | 1003120304 |
---|---|
Provider Name | Ms. Evelyn Zirkle |
First Address | Virginia Beach, VA 23464-5368 |
Second Address | Virginia Beach, VA 23464-5368 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2010 |
Last Update Date | 29/07/2010 |