Individual
DONNA MARIE CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
73 PIEDMONT DR, WHITESBURG, KY 41858-7668
(606) 633-3167
Mailing address
PO BOX 846, HAYSI, VA 24256-0846
(276) 865-0324
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
0131000473
VA
224Z00000X
Occupational Therapy Assistant
Primary
135586
KY
Other
Enumeration date
10/17/2013
Last updated
11/16/2020
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