Individual
KATIE WAHLSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
236 COMMONS WAY, WILLIAMSBURG, VA 23185
(757) 565-1724
Mailing address
1503 WOODBRIDGE DR, NEWPORT NEWS, VA 23608
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001577
VA
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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