Individual
VANESSA MIZELLE EGGLESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
77 SPARTAN CIR, RIDGEWAY, VA 24148-2900
(276) 956-4030
Mailing address
1607 SPRUCE STREET EXT, MARTINSVILLE, VA 24112-5814
(276) 632-7146
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000083
VA
Other
Enumeration date
03/10/2010
Last updated
03/10/2010
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