Provider Demographics
NPI:1609904465
Name:SPIEGEL, SHOSHANA RHEA (MHS, OTR,L)
Entity Type:Individual
Prefix:MS
First Name:SHOSHANA
Middle Name:RHEA
Last Name:SPIEGEL
Suffix:
Gender:F
Credentials:MHS, OTR,L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12908 NEW PARKLAND DR
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-2645
Mailing Address - Country:US
Mailing Address - Phone:703-742-9334
Mailing Address - Fax:703-742-8401
Practice Address - Street 1:1035 STERLING RD
Practice Address - Street 2:SUITE 104
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-3868
Practice Address - Country:US
Practice Address - Phone:703-464-8550
Practice Address - Fax:703-742-8401
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119000428225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics