Provider Demographics
NPI:1598703068
Name:WALLSCHLAEGER, NAJWA J (OTRL)
Entity Type:Individual
Prefix:
First Name:NAJWA
Middle Name:J
Last Name:WALLSCHLAEGER
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:NAJWA
Other - Middle Name:
Other - Last Name:JARJOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:8525 ROLLING RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-3673
Mailing Address - Country:US
Mailing Address - Phone:703-393-1667
Mailing Address - Fax:
Practice Address - Street 1:8525 ROLLING RD STE 300
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-3673
Practice Address - Country:US
Practice Address - Phone:703-393-1667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119001939225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1598703068Medicaid
00W355O06Medicare PIN
Q25713Medicare UPIN
P01584737Medicare PIN
Q51890AMedicare PIN