Individual
SUDITH EMIS HAIRSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
50 WELLESLEY DR, NEWPORT NEWS, VA 23606-4046
(757) 930-1075
Mailing address
47 RICHLAND DR, NEWPORT NEWS, VA 23608-1308
(757) 971-1110
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000803
VA
Other
Enumeration date
11/26/2013
Last updated
11/26/2013
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