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NPI Code Detail

MEDICARE: KRISTIN GOOD OTR/L

MEDICARE: KRISTIN GOOD 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 Therapist0119004343VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710901079
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN GOOD OTR/L
Provider Business Mailing Address
First Line : 4700 ELDON CT
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-7226
Country : US
Telephone Number : 757-491-4195
Fax Number :
Provider Business Practice Location Address
First Line : 1400 FORDHAM DR
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23464-5368
Country : US
Telephone Number : 757-361-3954
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 07/08/2007

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