Individual
BLAIR ELEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
500 MASONIC LN, RICHMOND, VA 23223-5557
(804) 222-1694
Mailing address
14320 GATEWOOD RD, SOUTH PRINCE GEORGE, VA 23805-8066
(804) 895-3003
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131-001946
VA
Other
Enumeration date
02/13/2018
Last updated
02/13/2018
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