Provider Demographics
NPI:1578983441
Name:VAN-BUENDIA, LAN (MS OTR/L, CHT)
Entity Type:Individual
Prefix:
First Name:LAN
Middle Name:
Last Name:VAN-BUENDIA
Suffix:
Gender:F
Credentials:MS OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7536 GARDNER PARK DR
Mailing Address - Street 2:SUITE 7536
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3414
Mailing Address - Country:US
Mailing Address - Phone:703-754-4770
Mailing Address - Fax:
Practice Address - Street 1:7536 GARDNER PARK DR
Practice Address - Street 2:SUITE 7536
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3414
Practice Address - Country:US
Practice Address - Phone:703-754-4770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-18
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119002732225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand