Individual
REBECCA BISHOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
100 N MAIN ST, SUFFOLK, VA 23434
(757) 925-6764
Mailing address
100 N MAIN ST, SUFFOLK, VA 23434-4529
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001892
VA
Other
Enumeration date
11/17/2017
Last updated
11/09/2018
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