Individual
VIVIANETTE MENENDEZ NIEVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
16 IRVING AVE N, COLONIAL BEACH, VA 22443-2324
(787) 671-7593
Mailing address
3301 MCCLELLAN DR, FREDERICKSBURG, VA 22408-0296
(787) 671-7593
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119008961
VA
Other
Enumeration date
02/23/2023
Last updated
02/23/2023
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