Individual
ASATA VIRGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
635 MINNESTOTT WAY, DURHAM, NC 27704-1399
(860) 833-3758
Mailing address
635 MINNESTOTT WAY, DURHAM, NC 27704-1399
(860) 833-3758
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
09/07/2021
Last updated
09/07/2021
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