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NPI Code Detail

MEDICARE: MRS. SHONDA R NELSON OTR/L

MEDICARE: MRS. SHONDA R NELSON OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist0119005612VA

General Provider Information

NPI Number : 1255672150
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHONDA R NELSON OTR/L
Provider Business Mailing Address
First Line : 2110 WASHINGTON BLVD
Second Line :
City : ARLINGTON
State : VA
Zip : 22204-5719
Country : US
Telephone Number : 703-228-6000
Fax Number :
Provider Business Practice Location Address
First Line : 2110 WASHINGTON BLVD
Second Line :
City : ARLINGTON
State : VA
Zip : 22204-5719
Country : US
Telephone Number : 703-228-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2013
Last Update Date : 10/28/2021

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