Individual
GIFTY BOADU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1936 OPITZ BLVD, WOODBRIDGE, VA 22191-3360
(540) 841-4443
Mailing address
4528 PLANK RD, FREDERICKSBURG, VA 22407-0141
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001945
VA
Other
Enumeration date
06/25/2019
Last updated
06/25/2019
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