Healthcare Provider Details

I. General information

NPI: 1750346185
Provider Name (Legal Business Name): KAREN WAWRZYN MS OTL CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 09/17/2020
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 BOULDERS PKWY STE 200
NORTH CHESTERFIELD VA
23225-4067
US

IV. Provider business mailing address

7650 E PARHAM RD STE 100
RICHMOND VA
23294-4376
US

V. Phone/Fax

Practice location:
  • Phone: 804-560-5595
  • Fax: 804-560-9029
Mailing address:
  • Phone: 804-282-6338
  • Fax: 804-285-3237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number119000452
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: