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Individual

ABIGAIL ELIZABETH BROADHURST

Active
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Individual

ABIGAIL ELIZABETH BROADHURST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119008398
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0119008398
COMMONWEALTH OF VA DEPARTMENT OF HEALTH PROFESSIONS
VA
01
431134
NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY
MD
Enumeration date
04/28/2020
Last updated
05/02/2020
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