Provider Demographics
NPI:1952446460
Name:NEEDHAM, JANET
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:NEEDHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11800 BRETON CT
Mailing Address - Street 2:12
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-3222
Mailing Address - Country:US
Mailing Address - Phone:703-391-1799
Mailing Address - Fax:
Practice Address - Street 1:8348 TRAFORD LN
Practice Address - Street 2:SUITE 200
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1663
Practice Address - Country:US
Practice Address - Phone:703-569-7500
Practice Address - Fax:703-866-0158
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119002897225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics