MEDICARE: ELIZABETH LOESCHEN

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	224Z00000X	Occupational Therapy Assistant	0131002740	VA

General Provider Information

NPI Number	:	1952258717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH LOESCHEN

Provider Business Mailing Address
First Line	:	206 WILLIAMSON RD SE APT 108
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24011-1809
Country	:	US
Telephone Number	:	540-750-6364
Fax Number	:

Provider Business Practice Location Address
First Line	:	1527 GRANDIN RD SW
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24015-2305
Country	:	US
Telephone Number	:	540-342-9525
Fax Number	:

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

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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