Individual
CARLA PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 DEER RUN RD, DANVILLE, VA 24540-2863
(434) 797-5531
Mailing address
1719 AVONDALE DR APT 10, ALTAVISTA, VA 24517-1000
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001813
VA
Other
Enumeration date
05/07/2018
Last updated
05/07/2018
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