Individual
MRS. MEGAN LEIGH WITTENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT/L
Contact information
Practice address
14318 CAMACK TRL, MIDLOTHIAN, VA 23114-4328
(330) 322-0212
Mailing address
14318 CAMACK TRL, MIDLOTHIAN, VA 23114-4328
(330) 322-0212
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119005510
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841425063
NPI
VA
Enumeration date
05/18/2009
Last updated
06/21/2012
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