Individual
MS. JESSICA L TOLER-ELAYAZRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
7350 WICHITA CT, APT 23, MANASSAS, VA 20109-6462
(304) 890-3924
Mailing address
7350 WICHITA CT, APT 23, MANASSAS, VA 20109-6462
(304) 890-3924
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001129
VA
224Z00000X
Occupational Therapy Assistant
C1778
WV
224Z00000X
Occupational Therapy Assistant
OTA001348
GA
Other
Enumeration date
04/16/2013
Last updated
04/16/2013
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