Individual
PATRICIA MAYO CONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3772 KENWICK TRL, ROANOKE, VA 24018-4944
(540) 989-4418
Mailing address
3772 KENWICK TRL, ROANOKE, VA 24018-4944
(540) 989-4418
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000033
VA
Other
Enumeration date
02/24/2013
Last updated
02/24/2013
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