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General NPI Number Information
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NPI Number | 1891756722
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Entity Type | Individual
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Provider Name | PAMELA A. WITTHAUS OTR/L, CHT
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Gender | Female
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Dates
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Enumeration Date | 03/30/2006
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Last Update Date | 05/08/2018
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Provider Practice Location Address
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Address Line | 6970 FOX HUNT LN
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City | GLOUCESTER
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State | VA
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Zip | 23061-5394
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Country | US
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Telephone | 804-694-8111
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Fax | 804-694-5574
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Provider Business Mailing Address
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Address Line | PO BOX 69030
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City | BALTIMORE
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State | MD
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Zip | 21264-9030
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Country | US
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Telephone | 757-873-2302
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Fax | 757-873-2306
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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 | 0119002323
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License Number State | VA
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