Individual
MR. STEVEN BRADLEY HOUSEHOLDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
2631 BRAMBLETON AVE SW, ROANOKE, VA 24015-4305
(540) 774-3485
Mailing address
2631 BRAMBLETON AVE SW, ROANOKE, VA 24015-4305
(540) 774-3485
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000419
VA
Other
Enumeration date
08/04/2010
Last updated
08/04/2010
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