Individual
MS. MADHUMITA GUHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
12837 HOADLY MANOR DR, MANASSAS, VA 20112-5581
(724) 766-0971
Mailing address
12837 HOADLY MANOR DR, MANASSAS, VA 20112-5581
(724) 766-0971
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001417
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0131001417
COMMONWEALTH OF VA, DEPT OF HEALTH PROFESSIONALS
VA
Enumeration date
09/19/2018
Last updated
09/19/2018
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