Healthcare Provider Details

I. General information

NPI: 1114585510
Provider Name (Legal Business Name): NATALIE P VRANICH OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2019
Last Update Date: 05/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 LLEWELLYN AVE UNIT 3201
NORFOLK VA
23504-1203
US

IV. Provider business mailing address

4505 MAIN ST STE 102
VIRGINIA BEACH VA
23462-3376
US

V. Phone/Fax

Practice location:
  • Phone: 757-625-5363
  • Fax:
Mailing address:
  • Phone: 814-243-4864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119007787
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: