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General NPI Number Information
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NPI Number | 1265253173
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Entity Type | Individual
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Provider Name | ELSA ANTAL MSOT, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 19775 BELMONT EXECUTIVE PLZ STE 125
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City | ASHBURN
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State | VA
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Zip | 20147-7606
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Country | US
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Telephone | 571-498-7752
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Fax |
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Provider Business Mailing Address
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Address Line | 2055 HATCHERS MILL RD
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City | MARSHALL
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State | VA
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Zip | 20115-3645
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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 | 0119010665
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License Number State | VA
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