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General NPI Number Information
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NPI Number | 1124660493
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Entity Type | Individual
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Provider Name | VICTORIA ANN WALTERS MSOT, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/08/2019
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 185 OLD BROADWAY
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City | HASTINGS ON HUDSON
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State | NY
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Zip | 10706-3801
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Country | US
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Telephone | 914-478-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 129 PARKSIDE DR
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City | SUFFERN
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State | NY
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Zip | 10901-7839
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Country | US
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Telephone |
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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 | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 024088
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 024088
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 46TR00903200
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License Number State | NJ
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