Individual
GREESHMA THOTAKURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3923 BEEKER MILL PL, CHANTILLY, VA 20151-3388
(248) 303-3693
Mailing address
3923 BEEKER MILL PL, CHANTILLY, VA 20151-3388
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119004509
VA
Other
Enumeration date
03/17/2016
Last updated
03/17/2016
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