Provider Demographics
NPI:1992182943
Name:OCHS, VANESSA ANAYA (MOTR/L)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:ANAYA
Last Name:OCHS
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:VANESSA
Other - Middle Name:
Other - Last Name:ANAYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOTR/L
Mailing Address - Street 1:2704 N OAK ST BLDG A2
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-5900
Mailing Address - Country:US
Mailing Address - Phone:229-253-1009
Mailing Address - Fax:229-253-1039
Practice Address - Street 1:2704 N OAK ST BLDG A2
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-5900
Practice Address - Country:US
Practice Address - Phone:229-253-1009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-29
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3368225XP0200X
GAOT007430225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003224876AMedicaid
NM10171568Medicaid
NM326556OtherMEDICARE