Individual
DEBRA K SHORES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
6251 OLD DOMINION DR, MC LEAN, VA 22101-4827
(561) 351-5394
Mailing address
6251 OLD DOMINION DR, MC LEAN, VA 22101-4827
(561) 351-5394
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000632
VA
Other
Enumeration date
08/16/2013
Last updated
08/16/2013
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