Healthcare Provider Details

I. General information

NPI: 1942116157
Provider Name (Legal Business Name): KARLA MARIEL ESTRADA OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7329 BOULDER VIEW LN
NORTH CHESTERFIELD VA
23225-4953
US

IV. Provider business mailing address

1103 PORTER ST APT A
RICHMOND VA
23224-2151
US

V. Phone/Fax

Practice location:
  • Phone: 804-562-7307
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119011568
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: