Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2305208474 | VA |
N | 2251N0400X | Physical Therapist - Neurology | 4143 | SC |
N | 225X00000X | Occupational Therapist | 1870 | SC |
NPI | 1265618409 |
---|---|
Provider Name | Rebecca C. English |
First Address | Newport News, VA 23606-1990 |
Second Address | Newport News, VA 23608-4416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2008 |
Last Update Date | 17/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1265618409 | MEDICAID QMB PROVIDER ID (01) | VA |
C05954 | MEDICARE GROUP PTAN (01) | VA |