Provider Demographics
NPI:1043281652
Name:HERRINGTON, JENNIFER W (DPT,OCS)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:W
Last Name:HERRINGTON
Suffix:
Gender:F
Credentials:DPT,OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8400 RADFORD AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22309-2585
Mailing Address - Country:US
Mailing Address - Phone:571-481-4547
Mailing Address - Fax:571-551-6419
Practice Address - Street 1:8400 RADFORD AVE STE 100
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22309
Practice Address - Country:US
Practice Address - Phone:571-481-4547
Practice Address - Fax:571-551-6419
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23050066002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2305006600OtherVA LICENSE