Provider Demographics
NPI:1043766637
Name:THE WRITE OT
Entity Type:Organization
Organization Name:THE WRITE OT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ILYSE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CANFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:OT/L
Authorized Official - Phone:804-551-2334
Mailing Address - Street 1:3420 PUMP ROAD
Mailing Address - Street 2:#172
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3420 PUMP RD
Practice Address - Street 2:#172
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-1111
Practice Address - Country:US
Practice Address - Phone:804-551-2334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119004864225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty