Provider Demographics
NPI:1679824866
Name:VIRGIN ISLANDS OCCUPATIONAL THERAPY LLC
Entity Type:Organization
Organization Name:VIRGIN ISLANDS OCCUPATIONAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:340-626-2960
Mailing Address - Street 1:9149 SUGAR ESTATE STE. 209A
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-2213
Mailing Address - Country:US
Mailing Address - Phone:340-228-2068
Mailing Address - Fax:
Practice Address - Street 1:9149 SUGAR ESTATE STE. 209A
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-2213
Practice Address - Country:US
Practice Address - Phone:340-228-2068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-27
Last Update Date:2013-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI1316227119OtherNPPES