Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 0119004688 | VA |
NPI | 1063686855 |
---|---|
Provider Name | Ms. Kelly K. Lefler |
First Address | Fredericksburg, VA 22401-5719 |
Second Address | Fredericksburg, VA 22401-5719 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2008 |
Last Update Date | 14/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4978145 | (05) | VA |