Individual
CARA J. VANDALE
Active
Individual
CARA J. VANDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
256
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000204383
OH MEDICAID UNISON
OH
01
—
000000217244
ANTHEM BCBS
—
01
—
001720898
MOUNTAIN STATE BCBS
—
05
—
0159443000
—
WV
01
—
670001502
RR MEDICARE
—
01
—
P00884476
WV RAIL ROAD MEDICARE
WV
Enumeration date
07/15/2006
Last updated
03/17/2011
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