Provider Demographics
NPI:1740636513
Name:QUESENBERRY, CAROL (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:
Last Name:QUESENBERRY
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 1:5668 WAYLAND DR
Mailing Address - Street 2:
Mailing Address - City:CROZET
Mailing Address - State:VA
Mailing Address - Zip Code:22932-3101
Mailing Address - Country:US
Mailing Address - Phone:434-760-0009
Mailing Address - Fax:
Practice Address - Street 1:339 WESTMINISTER DR
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2111
Practice Address - Country:US
Practice Address - Phone:540-949-8665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119000113225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist