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General NPI Number Information
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NPI Number | 1053798488
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Entity Type | Individual
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Provider Name | MONICA KHLEANG
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Gender | Female
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Dates
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Enumeration Date | 05/06/2015
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 1600 WESTBROOK AVE
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City | RICHMOND
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State | VA
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Zip | 23227-3337
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Country | US
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Telephone | 703-585-5178
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Fax |
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Provider Business Mailing Address
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Address Line | 14031 PLANTERS WALK DR
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City | MIDLOTHIAN
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State | VA
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Zip | 23113-3776
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Country | US
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Telephone | 703-585-5178
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Fax |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 0131001084
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License Number State | VA
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