Individual
CAITLIN BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1401 HALSTEAD AVE, NORFOLK, VA 23502-2003
(757) 857-0481
Mailing address
1401 HALSTEAD AVE, NORFOLK, VA 23502-2003
(757) 857-0481
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001171
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0131001171
STATE BOARD OF HEALTH
VA
Enumeration date
02/20/2019
Last updated
02/20/2019
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