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General NPI Number Information
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NPI Number | 1699556332
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Entity Type | Organization
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Legal Business Name | UNIQUELY INDEPENDENT LLC
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Dates
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Enumeration Date | 10/09/2023
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 729 THIMBLE SHOALS BLVD STE 5-C1
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4217
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Country | US
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Telephone | 757-863-9183
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Fax |
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Provider Business Mailing Address
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Address Line | 1706 TODDS LN # 236
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City | HAMPTON
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State | VA
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Zip | 23666-3123
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Country | US
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Telephone | 757-863-9183
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST/ OWNER
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Name | KELCIE RICHBURG
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Credential | OTR/L
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Telephone | 757-863-9183
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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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