Provider Demographics
NPI:1508133844
Name:WARD, GRETCHEN RENEE (MS, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:GRETCHEN
Middle Name:RENEE
Last Name:WARD
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 1:9270 BYRD DR
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-5921
Mailing Address - Country:US
Mailing Address - Phone:571-247-1890
Mailing Address - Fax:
Practice Address - Street 1:9270 BYRD DR
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-5921
Practice Address - Country:US
Practice Address - Phone:571-247-1890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015615225X00000X
VA0119006702225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist