Individual
URSULA BENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
12191 CLIPPER DR, LAKE RIDGE, VA 22192-2237
(703) 496-3486
Mailing address
8220 GUNSTON COMMONS WAY, LORTON, VA 22079-5026
(254) 702-0170
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000656
VA
Other
Enumeration date
04/17/2013
Last updated
04/17/2013
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