Individual
SUSIE JOY VILLANUEVA SWAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3100 SHORE DR, VIRGINIA BEACH, VA 23451-1199
(757) 496-1690
Mailing address
1401 CORNFIELD CT, VIRGINIA BEACH, VA 23464-6438
(757) 971-1260
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001620
VA
Other
Enumeration date
10/06/2018
Last updated
10/06/2018
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