Individual
MRS. JOETTE PANTEL THACKERAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
50 WELLESLEY DR, NEWPORT NEWS, VA 23606-4046
(757) 223-5474
Mailing address
515 MASSELL CT, NEWPORT NEWS, VA 23606-2126
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001380
VA
Other
Enumeration date
12/05/2017
Last updated
12/05/2017
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