Provider Demographics
NPI:1699556332
Name:UNIQUELY INDEPENDENT LLC
Entity type:Organization
Organization Name:UNIQUELY INDEPENDENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELCIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHBURG
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:757-863-9183
Mailing Address - Street 1:1706 TODDS LN # 236
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-3123
Mailing Address - Country:US
Mailing Address - Phone:757-863-9183
Mailing Address - Fax:
Practice Address - Street 1:729 THIMBLE SHOALS BLVD STE 5-C1
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4217
Practice Address - Country:US
Practice Address - Phone:757-863-9183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty