Healthcare Provider Details

I. General information

NPI: 1336360817
Provider Name (Legal Business Name): KATHLEEN MARIE YOPP OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 06/09/2023
Certification Date: 06/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

637 KINGSBOROUGH SQ STE A
CHESAPEAKE VA
23320-4944
US

IV. Provider business mailing address

637 KINGSBOROUGH SQ STE A
CHESAPEAKE VA
23320-4944
US

V. Phone/Fax

Practice location:
  • Phone: 757-698-4681
  • Fax: 757-401-4441
Mailing address:
  • Phone: 757-698-4681
  • Fax: 757-401-4441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number0119002427
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: