Provider Demographics
NPI:1275798159
Name:DEHNER BANYAS, JILL (PT)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:DEHNER BANYAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 LYNCH ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-2116
Mailing Address - Country:US
Mailing Address - Phone:530-386-1632
Mailing Address - Fax:
Practice Address - Street 1:507 CAPITOL CT NE STE 100
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-7705
Practice Address - Country:US
Practice Address - Phone:202-524-2320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT871492225100000X
VA2305205557225100000X, 2251P0200X
MD250522251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics