Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Eli Samuel Nolasco

Individual provider Occupational Therapy Assistant · NPI 1063174670

Eli Samuel Nolasco is an Occupational Therapy Assistant in Shepherdstown, West Virginia. Practices as a sole proprietor. Licensed in West Virginia.

Licensed in
WV
In the registry since
2021
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Practice location Address checks out

80 Maddex Dr
Shepherdstown, WV 25443-4305
Phone: (304) 876-9422
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence C2395 (WV)

Record details

NPI number1063174670
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 11, 2021
Last updated in NPPESOctober 11, 2021
Certification dateOctober 11, 2021
Mailing address127 Averrell Ave, Winchester, VA 22603-5822

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