Individual
DANA BLAIR CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
3216 MEADOWBROOK LN, CHESAPEAKE, VA 23321-5440
(757) 651-1137
(757) 606-2520
Mailing address
3216 MEADOWBROOK LN, CHESAPEAKE, VA 23321-5440
(757) 651-1137
(757) 606-2520
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119002296
VA
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10066936
OPTIMA HEALTH
VA
01
—
271537264
TRICARE PRIME
VA
05
—
271537264
—
VA
Enumeration date
07/14/2008
Last updated
07/05/2023
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