Provider Demographics
NPI:1225030679
Name:ELWOOD, ANNETTE (OT)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:ELWOOD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4165 QUARLES CT
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3576
Mailing Address - Country:US
Mailing Address - Phone:540-434-1664
Mailing Address - Fax:540-437-0052
Practice Address - Street 1:4165 QUARLES CT
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3576
Practice Address - Country:US
Practice Address - Phone:540-434-1664
Practice Address - Fax:540-437-0052
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119000901225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q11544Medicare UPIN
VA004080H96Medicare ID - Type Unspecified
VA0636510001Medicare NSC
VA004080H96Medicare ID - Type UnspecifiedANTHEM