Individual
MISS AMY LEA WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
14906 JEFFERSON DAVIS HWY, WOODBRIDGE, VA 22191-4016
(703) 491-5338
Mailing address
6804 METEOR PL APT 101, SPRINGFIELD, VA 22150-1940
(765) 749-0352
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119004482
VA
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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