Individual
SKYLAR WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
6401 AUBURN DR, VIRGINIA BEACH, VA 23464-3601
(757) 420-1485
Mailing address
3088 HUNGARIAN RD, VIRGINIA BEACH, VA 23457-1006
(757) 621-4449
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001059
VA
Other
Enumeration date
10/08/2012
Last updated
10/08/2012
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