Individual
HALLIE LIFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
313 CLOVELLY RD, RICHMOND, VA 23221-3701
(804) 513-6797
Mailing address
1610 FOREST AVE, RICHMOND, VA 23229-5009
(804) 282-4596
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0119005726
VA
Other
Enumeration date
06/26/2015
Last updated
06/26/2015
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