Provider Demographics
NPI:1164741476
Name:THRASHER, ANITA CHILSON (OTR)
Entity Type:Individual
Prefix:MS
First Name:ANITA
Middle Name:CHILSON
Last Name:THRASHER
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 1:6312 AUBURN DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-3717
Mailing Address - Country:US
Mailing Address - Phone:757-523-0457
Mailing Address - Fax:757-547-8788
Practice Address - Street 1:6312 AUBURN DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-3717
Practice Address - Country:US
Practice Address - Phone:757-523-0457
Practice Address - Fax:757-547-8788
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119000122225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist