Provider Demographics
NPI:1982836458
Name:NAPOLITANO, NICOLE RENEE (OT)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:RENEE
Last Name:NAPOLITANO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2875 BARN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-6389
Mailing Address - Country:US
Mailing Address - Phone:540-639-5786
Mailing Address - Fax:540-633-0787
Practice Address - Street 1:2875 BARN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-6389
Practice Address - Country:US
Practice Address - Phone:540-639-5786
Practice Address - Fax:540-633-0787
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119004944225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1487759957Medicaid
VA1487759957Medicare NSC