Individual
CARRIE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4489 BURNING TREE CT, SUFFOLK, VA 23435-2833
(757) 636-5551
Mailing address
4489 BURNING TREE CT, SUFFOLK, VA 23435-2833
(757) 636-5551
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000851
VA
Other
Enumeration date
10/02/2017
Last updated
07/21/2022
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