Provider Demographics
NPI:1689092280
Name:ASHTAPUTRE, VISHAKHA (OTR/L)
Entity Type:Individual
Prefix:
First Name:VISHAKHA
Middle Name:
Last Name:ASHTAPUTRE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43688 BALMORAL TER
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5605
Mailing Address - Country:US
Mailing Address - Phone:213-304-1672
Mailing Address - Fax:
Practice Address - Street 1:3101 16TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3302
Practice Address - Country:US
Practice Address - Phone:213-304-1672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT010000965225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist