Provider Demographics
NPI:1518119734
Name:PICOZZI, LYNNETTE M (PT)
Entity Type:Individual
Prefix:
First Name:LYNNETTE
Middle Name:M
Last Name:PICOZZI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LYNNETTE
Other - Middle Name:
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5252 LYNGATE CT STE 203
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1673
Mailing Address - Country:US
Mailing Address - Phone:703-239-2300
Mailing Address - Fax:
Practice Address - Street 1:5211 W BROAD ST STE 101
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3000
Practice Address - Country:US
Practice Address - Phone:804-288-3025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP11009225100000X
VA2305204771225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist