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General NPI Number Information
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NPI Number | 1003638073
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Entity Type | Individual
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Provider Name | EULAMAE RUTLEDGE MYERS
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Gender | Female
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Dates
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Enumeration Date | 10/30/2024
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 370 CLEVELAND PL
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-6529
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Country | US
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Telephone | 757-718-3675
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Fax | 757-321-8837
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Provider Business Mailing Address
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Address Line | 370 CLEVELAND PL
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-6529
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Country | US
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Telephone | 757-718-3675
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Fax | 757-321-8837
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 60802006
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 60802008
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 60808011
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 60808011
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License Number State | VA
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