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General NPI Number Information
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NPI Number | 1487181251
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Entity Type | Individual
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Provider Name | JACQUELYN ELIZABETH FOX OTD OTR/L APPLICANT
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Gender | Female
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 5700 WILLIAMSBURG LANDING DR
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City | WILLIAMSBURG
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State | VA
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Zip | 23185-5215
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Country | US
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Telephone | 757-565-6505
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5932
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-5215
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Country | US
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Telephone | 757-707-0805
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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 |
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License Number State |
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