Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 0119003976 | VA |
NPI | 1528291630 |
---|---|
Provider Name | Suzanne Fleming |
First Address | Doswell, VA 23047-2026 |
Second Address | Doswell, VA 23047-2026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2009 |
Last Update Date | 24/08/2009 |