Individual
MARYSSA EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2133 MONTGOMERY AVE, WOODBRIDGE, VA 22191-2655
(703) 494-3817
Mailing address
2454 KILPATRICK PL, DUMFRIES, VA 22026-2536
(540) 604-0838
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131002906
VA
Other
Enumeration date
11/18/2020
Last updated
01/20/2025
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