Individual
THERESA M EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
431 LOFTON RD, RAPHINE, VA 24472-2821
(540) 457-1219
Mailing address
431 LOFTON RD, RAPHINE, VA 24472-2821
(540) 457-1219
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000210
VA
Other
Enumeration date
02/23/2007
Last updated
02/02/2011
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