Individual
ELIZABETH KINGMAN WINEGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
6157 FULLER CT, ALEXANDRIA, VA 22310-2541
(703) 967-7152
Mailing address
7202 WICKFORD DR, ALEXANDRIA, VA 22315-4213
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119004704
VA
225X00000X
Occupational Therapist
1066845
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
234496
—
OR
Enumeration date
09/20/2006
Last updated
05/06/2008
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