Individual
MARY GRACE RAFANAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1015 W 47TH ST, NORFOLK, VA 23529-0001
(757) 683-7041
Mailing address
704 REDLEAFE CIR, CHESAPEAKE, VA 23320-3225
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000985
VA
Other
Enumeration date
03/11/2016
Last updated
03/11/2016
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