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General NPI Number Information
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NPI Number | 1093445165
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Entity Type | Organization
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Legal Business Name | MARTHA JEFFERSON HOUSE
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Dates
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Enumeration Date | 06/13/2022
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Last Update Date | 06/13/2022
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Provider Practice Location Address
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Address Line | 1600 GORDON AVE
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-1944
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Country | US
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Telephone | 434-293-6136
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 GORDON AVE
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-1944
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Country | US
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Telephone | 434-293-6136
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | HEATHER JOANNA PARROTT
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Credential | DHSC, LNHA, CCC-SLP
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Telephone | 540-360-3027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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