Provider Demographics
NPI:1760838320
Name:CHAVEZ, SILVIA CAROLINA (COTA)
Entity Type:Individual
Prefix:MRS
First Name:SILVIA
Middle Name:CAROLINA
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4936 SAUQUOIT LN
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-5142
Mailing Address - Country:US
Mailing Address - Phone:571-235-0209
Mailing Address - Fax:
Practice Address - Street 1:4936 SAUQUOIT LN
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-5142
Practice Address - Country:US
Practice Address - Phone:571-235-0209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131001565224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant