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General NPI Number Information
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NPI Number | 1265047112
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Entity Type | Individual
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Provider Name | CHELSEA MAUREEN LANDRY OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/08/2020
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Last Update Date | 09/08/2020
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Provider Practice Location Address
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Address Line | 200 W 12TH ST STE A1-100
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City | WAYNESBORO
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State | VA
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Zip | 22980-4771
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Country | US
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Telephone | 540-941-5501
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Fax |
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Provider Business Mailing Address
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Address Line | 1945 BEECHCREST CT APT 104
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-6638
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Country | US
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Telephone | 908-399-9735
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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 | 0119008631
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License Number State | VA
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