Provider Demographics
NPI:1518282649
Name:WITSCHEY, ELLEN (OTR)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:WITSCHEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:WITSCHEY
Other - Last Name:DEROBERTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR
Mailing Address - Street 1:322 TUDOR DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22603-4245
Mailing Address - Country:US
Mailing Address - Phone:540-722-2833
Mailing Address - Fax:
Practice Address - Street 1:322 TUDOR DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22603-4245
Practice Address - Country:US
Practice Address - Phone:540-722-2833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119002874225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist