Basic Information
| Provider Information | |||||||||
| NPI: | 1104392711 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VERVERELI | ||||||||
| FirstName: | ELIZABETH | ||||||||
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| Credential: | OT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 133 ROSEMAR RD STE 1 | ||||||||
| Address2: | |||||||||
| City: | PARKERSBURG | ||||||||
| State: | WV | ||||||||
| PostalCode: | 261047609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3046932781 | ||||||||
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| Practice Location | |||||||||
| Address1: | 313 MACCORKLE AVE SW STE 100 | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 253031263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3047463704 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/22/2018 | ||||||||
| LastUpdateDate: | 10/22/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.