Provider Demographics
NPI:1891571287
Name:BELLVILLE, ELIZABETH (OTD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:BELLVILLE
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9402 WOOD CREEK CIR # 2240
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-9268
Mailing Address - Country:US
Mailing Address - Phone:571-328-1329
Mailing Address - Fax:
Practice Address - Street 1:6106 HEALTH CENTER LN
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-6687
Practice Address - Country:US
Practice Address - Phone:540-785-1120
Practice Address - Fax:540-785-6201
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist