Individual
CASEY DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
83 CROSSROADS LN, FISHERSVILLE, VA 22939
(575) 590-5870
Mailing address
304 TEXAS LN, GOSHEN, VA 24439-2517
(575) 590-5870
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001320
VA
Other
Enumeration date
08/19/2014
Last updated
08/19/2014
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