Individual
MRS. NANCY VERVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.O.T.A.
Contact information
Practice address
2145 ELLERMAN DR, KINGMAN, AZ 86401-5023
(928) 753-3956
Mailing address
2145 ELLERMAN DR, KINGMAN, AZ 86401-5023
(928) 753-3956
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0412
AZ
Other
Enumeration date
02/12/2009
Last updated
02/12/2009
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