Healthcare Provider Details

I. General information

NPI: 1790600575
Provider Name (Legal Business Name): THOMAS WILLIAM OGDEN OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 BACK BAY CRES
VIRGINIA BEACH VA
23456-4401
US

IV. Provider business mailing address

361 BACK BAY CRES
VIRGINIA BEACH VA
23456-4401
US

V. Phone/Fax

Practice location:
  • Phone: 215-805-4763
  • Fax:
Mailing address:
  • Phone: 215-805-4763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119011466
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: