Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 0119007147 | VA |
N | 225XH1200X | Occupational Therapist - Hand | OT15718 | CA |
NPI | 1235484007 |
---|---|
Provider Name | Sarah W Villacarillo |
First Address | North Chesterfield, VA 23225-4067 |
Second Address | Richmond, VA 23226-1935 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2012 |
Last Update Date | 30/10/2020 |