Healthcare Provider Details

I. General information

NPI: 1932628849
Provider Name (Legal Business Name): MENDY BETH ADAMS MOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2017
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 GRAFTON LN
BERRYVILLE VA
22611-2576
US

IV. Provider business mailing address

208 OLD MILL RD
MARTINSBURG WV
25401-9219
US

V. Phone/Fax

Practice location:
  • Phone: 540-955-2400
  • Fax: 540-955-2400
Mailing address:
  • Phone: 304-263-5680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number-119005971
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: