Individual
MARYANN CENTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.R./L
Contact information
Practice address
6164 FULLER CT, ALEXANDRIA, VA 22310-2540
(571) 271-7308
Mailing address
15133 STILLFIELD PL, CENTREVILLE, VA 20120-3910
(703) 815-9003
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0119002303
VA
Other
Enumeration date
04/28/2010
Last updated
04/28/2010
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