Provider Demographics
NPI:1003194119
Name:SCHORR, TYLER (OT)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:SCHORR
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9914 FAIRFAX SQ
Mailing Address - Street 2:APT 66
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4214
Mailing Address - Country:US
Mailing Address - Phone:301-559-3199
Mailing Address - Fax:
Practice Address - Street 1:5501 BACKLICK RD
Practice Address - Street 2:SUITE 118
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-3933
Practice Address - Country:US
Practice Address - Phone:703-750-1204
Practice Address - Fax:703-750-1206
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119005395225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist