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General NPI Number Information
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NPI Number | 1982403366
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Entity Type | Individual
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Provider Name | VIELKA A FONDEUR ROBERTS
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Gender | Female
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 4560 PRINCESS ANNE
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City | VI
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State | VA
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Zip | 23462-7419
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Country | US
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Telephone | 757-495-4211
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Fax |
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Provider Business Mailing Address
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Address Line | 234 BRONTE TRCE
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-7419
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Country | US
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Telephone | 917-586-6349
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224ZF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapy Assistant
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License Number | 0131002616
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License Number State | VA
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