Individual
ELAINE WEIDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3540 VICTORY BLVD, YORKTOWN, VA 23693-3641
(757) 230-2202
Mailing address
655 S WILLOW ST, MANCHESTER, NH 03103-5714
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT011682
OH
225X00000X
Occupational Therapist
Primary
—
VA
Other
Enumeration date
08/18/2022
Last updated
08/18/2022
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