Provider Demographics
NPI:1124578406
Name:DYE, ELIZABETH B (OTR)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:B
Last Name:DYE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1933 SANDEE CRES
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-2307
Mailing Address - Country:US
Mailing Address - Phone:757-477-4332
Mailing Address - Fax:
Practice Address - Street 1:1933 SANDEE CRES
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2307
Practice Address - Country:US
Practice Address - Phone:757-477-4332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119002944225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist