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General NPI Number Information
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NPI Number | 1164390514
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Entity Type | Individual
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Provider Name | GLADYS M BOONE OTR
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Gender | Female
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 500 CLINIC DR
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City | CEDAR BLUFF
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State | VA
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Zip | 24609-9406
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Country | US
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Telephone | 276-202-3735
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Fax |
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Provider Business Mailing Address
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Address Line | 282 LINWOOD DR
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City | RICHLANDS
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State | VA
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Zip | 24641-3606
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0119010161
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License Number State | VA
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