Provider Demographics
NPI:1801300033
Name:KOLAJO, MARGARET BOLA (OT)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:BOLA
Last Name:KOLAJO
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 1:450 MAJESTIC DR
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-5069
Mailing Address - Country:US
Mailing Address - Phone:443-752-2942
Mailing Address - Fax:
Practice Address - Street 1:700 RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:RADFORD
Practice Address - State:VA
Practice Address - Zip Code:24141-2430
Practice Address - Country:US
Practice Address - Phone:540-633-6533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119-007525225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist