Provider Demographics
NPI:1427284967
Name:PURGASON, MANDY MICHELLE (COTA/L)
Entity type:Individual
Prefix:MS
First Name:MANDY
Middle Name:MICHELLE
Last Name:PURGASON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MRS
Other - First Name:MANDY
Other - Middle Name:PURGASON
Other - Last Name:RADFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:508 RISON ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541
Mailing Address - Country:US
Mailing Address - Phone:434-441-2243
Mailing Address - Fax:
Practice Address - Street 1:508 RISON ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541
Practice Address - Country:US
Practice Address - Phone:434-799-4540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131000005224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant