Individual
SUMMER VASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4600 POWDER MILL RD, BELTSVILLE, MD 20705-2675
(301) 477-7194
Mailing address
4600 POWDER MILL RD, BELTSVILLE, MD 20705-2675
(301) 477-7194
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119008817
VA
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Enumeration date
11/18/2020
Last updated
11/04/2022
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