Provider Demographics
NPI:1518319482
Name:CHANG, ERIN ELIZABETH (PTA)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:ELIZABETH
Last Name:CHANG
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:ELIZABETH
Other - Last Name:GARNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:6166 FULLER CT
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-2540
Mailing Address - Country:US
Mailing Address - Phone:703-719-6908
Mailing Address - Fax:703-313-0056
Practice Address - Street 1:6166 FULLER CT
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-2540
Practice Address - Country:US
Practice Address - Phone:703-719-6908
Practice Address - Fax:703-313-0056
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306604460225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant