Provider Demographics
NPI:1891275442
Name:KAVAL, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:KAVAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11157 MARQUIS RD
Mailing Address - Street 2:
Mailing Address - City:UNIONVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22567-2406
Mailing Address - Country:US
Mailing Address - Phone:540-854-7317
Mailing Address - Fax:
Practice Address - Street 1:12425 VILLAGE LOOP
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-4375
Practice Address - Country:US
Practice Address - Phone:540-321-1159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110003169225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist