STEPHANIE RENEE MERGENTIME

FAIRFAX, VA
NPI1306313275
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: MA  4609)
Additional Taxonomies224Z00000X Occupational Therapy Assistant
(Licence: VA  0131002089)
Enumeration Date2018-10-30
Last Update Date2021-08-06
Business Address
STEPHANIE RENEE MERGENTIME COTA
10701 MAIN ST
FAIRFAX, VA 22030
Phone number: 703-273-7705
Mailing Address
STEPHANIE RENEE MERGENTIME COTA
3954 BRICKERT PL
WOODBRIDGE, VA 22192-7447
Phone number: 256-226-3504