Individual
JAYMELYN HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
6405 BOYDTON PLANK RD, NORTH DINWIDDIE, VA 23803-7401
(804) 861-1324
Mailing address
16603 COX RD, CHURCH ROAD, VA 23833-3049
(804) 691-4518
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000789
VA
Other
Enumeration date
05/16/2013
Last updated
05/16/2013
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