Individual
CAMILLE MAELA ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2526 N MAIN ST, DANVILLE, VA 24540-2333
(434) 836-9510
Mailing address
523 LYNN ST APT 202, DANVILLE, VA 24541-1443
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119-008566
VA LICENSE
VA
Enumeration date
03/25/2020
Last updated
04/06/2020
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