Individual
GABRIELA ACIERNO VAN SICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 BUCKINGHAM STATION DR, APT 3I, MIDLOTHIAN, VA 23113-4636
(804) 560-9575
Mailing address
1301 BUCKINGHAM STATION DR APT 3C, MIDLOTHIAN, VA 23113-4631
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305208396
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2305208396
VA STATE PHYSICAL THERAPY LICENSE
VA
Enumeration date
11/07/2013
Last updated
11/11/2014
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