Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 251F00000X | Home Infusion | | | | No |
| 2 | 251G00000X | Hospice Care, Community Based | | | | No |
| 3 | 252Y00000X | Early Intervention Provider Agency | | | | No |
| 4 | 261QH0700X | Clinic/Center | Hearing and Speech | | | No |
| 5 | 261QR0401X | Clinic/Center | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | | | No |
| 6 | 235Z00000X | Speech-Language Pathologist | | | | No |
| 7 | 163W00000X | Registered Nurse | | | | No |
| 8 | 224Z00000X | Occupational Therapy Assistant | | | | No |
| 9 | 225100000X | Physical Therapist | | | | No |
| 10 | 225X00000X | Occupational Therapist | | | | No |
| 11 | 385H00000X | Respite Care | | | | No |
| 12 | 385HR2060X | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities | | | No |
| 13 | 385HR2065X | Respite Care | Respite Care, Physical Disabilities, Child | | | No |
| 14 | 251E00000X | Home Health | | | | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 1033359690 | MEDICAID | VIRGINIA | |