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Individual

PERETHA FAYE PATTERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
C.O.T.A.

Contact information

Practice address
15 SAINT WILLIAMS WAY, STAFFORD, VA 22556-3640
(540) 287-8002
Mailing address
15 SAINT WILLIAMS WAY, STAFFORD, VA 22556-3640
(540) 287-8002

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0131000208
COMMONWEALTH OF VIRGINIA, DEPARTMENT OF HEALTH PROFESSIONS, LICENSE
VA
Enumeration date
06/13/2007
Last updated
01/31/2011
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