Provider Demographics
NPI:1578349585
Name:STOLZE, DANIELLE (DPT)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:
Last Name:STOLZE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:GERUSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:7915 EDINBURGH DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-2906
Mailing Address - Country:US
Mailing Address - Phone:315-256-5831
Mailing Address - Fax:
Practice Address - Street 1:4027 OLLEY LN
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22032-1323
Practice Address - Country:US
Practice Address - Phone:315-256-5831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23052075242251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology