Individual
CHRISTINA GAYLE KOVACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14906 JEFFERSON DAVIS HWY, WOODBRIDGE, VA 22191-4016
(703) 491-6167
Mailing address
15159 KENTSHIRE DR, WOODBRIDGE, VA 22191-6524
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000610
VA
Other
Enumeration date
08/12/2010
Last updated
08/12/2010
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