Individual
VIRGINIA EKATERINA VANAUSDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
7701 POPLAR AVE, GERMANTOWN, TN 38138-3904
(901) 752-8444
Mailing address
1810 COOPER DR, DYERSBURG, TN 38024-2944
(573) 757-8703
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8052
TN
Other
Enumeration date
06/05/2025
Last updated
06/05/2025
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