Individual
LEANN DEXTRADEUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6401 AUBURN DR, VIRGINIA BEACH, VA 23464-3601
(757) 420-2512
Mailing address
6181 POCAHONTAS CLUB RD, VIRGINIA BEACH, VA 23457-1242
(757) 721-5496
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000585
VA
Other
Enumeration date
03/08/2011
Last updated
03/08/2011
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