Jane Elizabeth Dettra

NPI #1649769571 in Broadlands, Virginia

Provider Information

NPI Number: 1649769571
Entity Type: Individual
Name: Jane Elizabeth Dettra
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Enumeration Date: May 7, 2018
Last Updated: May 7, 2018

Practice Location

Address: 21000 EDUCATION CT
City: Broadlands
State: Virginia
ZIP Code: 20148-5526
Phone: (571) 252-2240

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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