Individual
ALYSON LEIGH GLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1309 KEMPSVILLE RD, NORFOLK, VA 23502-2205
(757) 461-5001
Mailing address
5232 BARDITH CIR, VIRGINIA BEACH, VA 23455-3858
(757) 461-5001
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000302
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0131000302
CERTIFIED OCCUPATIONAL THERAPY ASSISTANT LICENSE
VA
Enumeration date
08/06/2010
Last updated
08/06/2010
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