Individual
GRACE OLIVIA PRIVETTE MALAMALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13030 WARWICK BLVD, NEWPORT NEWS, VA 23602-8374
(757) 746-4843
Mailing address
13030 WARWICK BLVD, NEWPORT NEWS, VA 23602-8374
(757) 746-4843
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131002527
VA
Other
Enumeration date
07/06/2024
Last updated
03/16/2025
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