MEDICARE: TERESA ALLIA ARTIS OTD, OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	0119010077	VA

General Provider Information

NPI Number	:	1275491946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA ALLIA ARTIS OTD, OTR/L

Provider Business Mailing Address
First Line	:	1827 BOGESE DR
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23805-2919
Country	:	US
Telephone Number	:	804-926-7258
Fax Number	:

Provider Business Practice Location Address
First Line	:	1510 BAINBRIDGE ST APT 110
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23224-2039
Country	:	US
Telephone Number	:	804-926-7258
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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