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General NPI Number Information
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NPI Number | 1558026427
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Entity Type | Organization
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Legal Business Name | GREENLEAF THERAPEUTIC SERVICES
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Dates
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Enumeration Date | 11/04/2021
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Last Update Date | 11/04/2021
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Provider Practice Location Address
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Address Line | 3626 13TH ST NW
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City | WASHINGTON
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State | DC
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Zip | 20010-1409
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Country | US
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Telephone | 301-448-9267
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Fax |
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Provider Business Mailing Address
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Address Line | 3626 13TH ST NW
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City | WASHINGTON
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State | DC
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Zip | 20010-1409
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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 | OWNER & OCCUPATIONAL THERAPIST
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Name | VICTORIA STEVENSON
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Credential | OTR/L
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Telephone | 301-448-9267
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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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