Individual
MRS. JOANNE CUSTER VANSICLEN I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.O.T.A.L.
Contact information
Practice address
526 PLEASANT VIEW RD, STAUNTON, VA 24401-6449
(504) 885-2696
Mailing address
526 PLEASANT VIEW RD, STAUNTON, VA 24401-6449
(504) 885-2696
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000152
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0131000152
COMMONWEALTH OF VA. DEPARTMENT OF HEALTH PROFESSIONS
VA
01
—
AA267245
NBCOT
PA
Enumeration date
02/06/2013
Last updated
02/06/2013
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