Provider Demographics
NPI:1750608154
Name:LEVI, VIRGINIA S (OT)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:S
Last Name:LEVI
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 1:110 SUNNY HILL DR
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-5553
Mailing Address - Country:US
Mailing Address - Phone:318-613-5888
Mailing Address - Fax:318-484-9913
Practice Address - Street 1:110 SUNNY HILL DR
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-5553
Practice Address - Country:US
Practice Address - Phone:318-613-5888
Practice Address - Fax:318-484-9913
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.200040225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist