Provider Demographics
NPI:1740931955
Name:BATTLE, CELESTE KEARRA (COTA/L)
Entity type:Individual
Prefix:MISS
First Name:CELESTE
Middle Name:KEARRA
Last Name:BATTLE
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5508 YATES LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-5909
Mailing Address - Country:US
Mailing Address - Phone:804-252-6841
Mailing Address - Fax:
Practice Address - Street 1:10300 THREE CHOPT RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-2070
Practice Address - Country:US
Practice Address - Phone:804-708-7041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131002618224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant