Individual
MRS. NICOLE JEANETTE GALLETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
40 BROAD STREET RD, MANAKIN SABOT, VA 23103-2213
(804) 291-7926
Mailing address
11118 CARRINGTON GREEN DR, GLEN ALLEN, VA 23060-3446
(804) 291-7926
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119003178
VA
Other
Enumeration date
01/16/2007
Last updated
07/08/2007
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