Healthcare Provider Details

I. General information

NPI: 1073577268
Provider Name (Legal Business Name): JONI VERCAMMEN OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 03/04/2022
Certification Date: 02/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 E PICCADILLY ST STE 11&14
WINCHESTER VA
22601-3971
US

IV. Provider business mailing address

7 CARNEGIE PLZ
CHERRY HILL NJ
08003-1000
US

V. Phone/Fax

Practice location:
  • Phone: 877-407-3422
  • Fax: 877-407-4329
Mailing address:
  • Phone: 877-407-3422
  • Fax: 877-407-4329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119006320
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC009069
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: