Healthcare Provider Details

I. General information

NPI: 1518436336
Provider Name (Legal Business Name): ASHLEY MARIE VREELAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2018
Last Update Date: 11/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 EPPES ST
HOPEWELL VA
23860-2717
US

IV. Provider business mailing address

17940 HALIFAX RD
CARSON VA
23830-8801
US

V. Phone/Fax

Practice location:
  • Phone: 804-541-1445
  • Fax:
Mailing address:
  • Phone: 804-691-3603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: