Provider Demographics
NPI:1134630999
Name:TUEL, NANCY LOUISE (COTA/L)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:LOUISE
Last Name:TUEL
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 DUNGADIN RD
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-5003
Mailing Address - Country:US
Mailing Address - Phone:540-636-2129
Mailing Address - Fax:
Practice Address - Street 1:110 LAUCK DR # 54
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22603-4282
Practice Address - Country:US
Practice Address - Phone:540-667-7830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131001804224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant