Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics |
NPI | 1013310119 |
---|---|
Provider Name | Sarah Tatlonghari |
First Address | Fairfax, VA 22030-6078 |
Second Address | Fairfax, VA 22030-6078 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2014 |
Last Update Date | 02/10/2014 |