Individual
MISS SUN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
5100 FILLMORE AVE, ALEXANDRIA, VA 22311-5069
(703) 845-5100
Mailing address
8287 SWOPE CT, SPRINGFIELD, VA 22153-1938
(703) 434-9935
Taxonomy
Speciality
Code
Description
License number
State
225XE0001X
Environmental Modification Occupational Therapist
—
VA
225XG0600X
Gerontology Occupational Therapist
Primary
0119006380
VA
225XP0019X
Physical Rehabilitation Occupational Therapist
—
VA
Other
Enumeration date
11/20/2019
Last updated
11/20/2019
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