Individual
THERESA COCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
401 MONTICELLO AVE, LYNCHBURG, VA 24501-5617
(434) 522-3716
Mailing address
401 MONTICELLO AVE, LYNCHBURG, VA 24501-5617
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119000305
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011900305
LICENSE
VA
Enumeration date
01/17/2012
Last updated
01/25/2016
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