Individual
CHARA CIVITELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OCCUPATIONAL THERAPY
Contact information
Practice address
5804 CHASE COMMONS COURT APT 207, BURKE, VA 22015
(323) 350-8395
Mailing address
5804 CHASE COMMONS CT APT 207, BURKE, VA 22015-4640
(323) 350-8395
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
0119006625
VA
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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