Provider Demographics
NPI:1609381334
Name:MIGNARDI, NADINE VICTORIA (OT/L)
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:VICTORIA
Last Name:MIGNARDI
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 FINIAL AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1420
Mailing Address - Country:US
Mailing Address - Phone:804-878-1496
Mailing Address - Fax:
Practice Address - Street 1:2206 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-2232
Practice Address - Country:US
Practice Address - Phone:804-878-1496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-04
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist