Individual
TERESA FITZPATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1931 HOLLAND RD, SUFFOLK, VA 23434-6760
(757) 925-4500
(757) 925-4592
Mailing address
2007 MEADE PKWY, SUFFOLK, VA 23434-4259
(757) 539-6300
(757) 539-0704
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119003934
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004979796
—
VA
01
—
496633
MEDICARE
—
Enumeration date
05/21/2010
Last updated
05/21/2010
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