Individual
MRS. GILLIAN CROWLEY LIVESAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHS, OTRL
Contact information
Practice address
8270 WILLOW OAKS CORPORATE DR # 2120, FAIRFAX, VA 22031-4511
(571) 423-4864
Mailing address
8270 WILLOW OAKS CORPORATE DR # 2120, FAIRFAX, VA 22031-4511
(571) 423-4864
(217) 344-8047
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056006827
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113326
HEALTHLINK PROV ID
—
01
—
203
BLUE CROSS PROV ID
IL
01
—
4117
HAMP PROVIDER ID
IL
01
—
7216
PERSONALCARE PROV ID
—
Enumeration date
03/28/2007
Last updated
03/20/2018
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