Provider Demographics
NPI:1699497818
Name:COSENTINO, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:COSENTINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 DICK HUFF LN
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:VA
Mailing Address - Zip Code:24482-2574
Mailing Address - Country:US
Mailing Address - Phone:540-245-5133
Mailing Address - Fax:
Practice Address - Street 1:68 DICK HUFF LN
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:VA
Practice Address - Zip Code:24482-2574
Practice Address - Country:US
Practice Address - Phone:540-245-5133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119009652225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist