Individual
MRS. MARILYN DOMINECK PRIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
12997 NETTLES DR, NEWPORT NEWS, VA 23602-6913
(757) 249-2699
(757) 249-5589
Mailing address
100 DALZELL CT, YORKTOWN, VA 23693-2051
(757) 660-6113
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
224Z00000X
VA
Other
Enumeration date
01/31/2013
Last updated
01/31/2013
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