Individual
MS. PAMELA A. WITTHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L, CHT
Contact information
Practice address
6970 FOX HUNT LN, GLOUCESTER, VA 23061-5394
(804) 694-8111
(804) 694-5574
Mailing address
PO BOX 69030, BALTIMORE, MD 21264-9030
(757) 873-2302
(757) 873-2306
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119002323
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11446180
CAQH
VA
05
—
1891756722
—
VA
01
—
192945
BCBS (OCCUPATIONAL THERAPY)
VA
01
—
7596331
AETNA
VA
01
—
P00651588
RAILROAD MEDICARE
VA
Enumeration date
03/30/2006
Last updated
05/08/2018
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