Provider Demographics
NPI:1457649758
Name:MASCI, KRISTEN G (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:G
Last Name:MASCI
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4748 24TH RD N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-3552
Mailing Address - Country:US
Mailing Address - Phone:301-509-1461
Mailing Address - Fax:202-379-1797
Practice Address - Street 1:1301 PENNSYLVANIA AVE SE BSMT
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3027
Practice Address - Country:US
Practice Address - Phone:202-544-5439
Practice Address - Fax:202-379-1797
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
DCOT956225XP0200X
VA0119003125225XP0200X
DC956225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist