Lacey Feezor, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Clarksville, VA

NPI 1043783301 · NPPES record last updated Jan 9, 2019

Key facts

NPI
1043783301
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
0131001273 (VA)
Practice address
184 Buffalo Rd
Clarksville, VA 23927-9010
Phone
(434) 374-3025
NPI assigned
Jan 9, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0131001273VAMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 0131001273 VA Yes

Addresses

Primary practice location

184 Buffalo Rd
Clarksville, VA 23927-9010

Mailing address

184 Buffalo Rd
Clarksville, VA 23927-9010

Other providers in Clarksville, VA

All providers in Clarksville, VA · Occupational Therapy Assistant in Virginia

Sources for this page

Verify at the official NPI Registry.