Provider Demographics
NPI:1568665834
Name:MARONEY, JEANNE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:
Last Name:MARONEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14631 LEE HWY
Mailing Address - Street 2:SUITE 310
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-2112
Mailing Address - Country:US
Mailing Address - Phone:703-222-5903
Mailing Address - Fax:703-222-3765
Practice Address - Street 1:14631 LEE HWY
Practice Address - Street 2:SUITE 310
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-2112
Practice Address - Country:US
Practice Address - Phone:703-222-5903
Practice Address - Fax:703-222-3765
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305005473225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA196835OtherANTHEM
VA285489OtherMAMSI
VA7067339OtherAETNA
VA7067339OtherAETNA