Provider Demographics
NPI:1295400729
Name:RAWAT, TANVI (OTD)
Entity Type:Individual
Prefix:
First Name:TANVI
Middle Name:
Last Name:RAWAT
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42670 FRONTIER DR
Mailing Address - Street 2:
Mailing Address - City:BRAMBLETON
Mailing Address - State:VA
Mailing Address - Zip Code:20148-7207
Mailing Address - Country:US
Mailing Address - Phone:571-377-9168
Mailing Address - Fax:
Practice Address - Street 1:7001A LOISDALE RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-1904
Practice Address - Country:US
Practice Address - Phone:703-971-0602
Practice Address - Fax:703-971-0606
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119009151225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist