Provider Demographics
NPI:1073825774
Name:GILLIAM, CATHERINE SHARP (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:SHARP
Last Name:GILLIAM
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8021 KING EIDER DR
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-8938
Mailing Address - Country:US
Mailing Address - Phone:804-716-0921
Mailing Address - Fax:
Practice Address - Street 1:8021 KING EIDER DR
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23231-8938
Practice Address - Country:US
Practice Address - Phone:804-716-0921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119001832225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation