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General NPI Number Information
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NPI Number | 1821648098
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Entity Type | Individual
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Provider Name | KATIE L BUTTAFARRO OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/18/2019
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Last Update Date | 09/18/2019
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Provider Practice Location Address
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Address Line | 7820 BALTUSROL BLVD
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City | GAINESVILLE
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State | VA
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Zip | 20155-3270
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Country | US
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Telephone | 703-468-2750
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Fax |
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Provider Business Mailing Address
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Address Line | 841 OAK LEAF CT
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City | WARRENTON
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State | VA
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Zip | 20186-2159
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Country | US
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Telephone | 716-720-1572
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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 | 0119007494
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License Number State | VA
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