Provider Demographics
NPI:1770920167
Name:HOUSLER, ANITA L (COTA/L)
Entity type:Individual
Prefix:MS
First Name:ANITA
Middle Name:L
Last Name:HOUSLER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:LYN
Other - Last Name:NYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6401 AUBURN DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-3601
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6401 AUBURN DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-3601
Practice Address - Country:US
Practice Address - Phone:757-420-2512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-27
Last Update Date:2013-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0131000684224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant