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Individual

MS. JOANN DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTAL

Contact information

Practice address
8701 PELLINGTON PL, APT 1, HENRICO, VA 23294-4830
(313) 402-5468
Mailing address
8701 PELLINGTON PL, APT 1, HENRICO, VA 23294-4830
(313) 402-5468

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001008
VA
224Z00000X
Occupational Therapy Assistant
5202007160
MI

Other

Enumeration date
06/27/2012
Last updated
07/12/2013
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