Provider Demographics
NPI:1003413717
Name:BATISTA, DAPHNE MONIQUE
Entity type:Individual
Prefix:
First Name:DAPHNE
Middle Name:MONIQUE
Last Name:BATISTA
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 1:24600 MILLSTREAM DR
Mailing Address - Street 2:STE 380
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-5686
Mailing Address - Country:US
Mailing Address - Phone:703-810-5285
Mailing Address - Fax:571-407-5694
Practice Address - Street 1:24600 MILLSTREAM DR STE 380
Practice Address - Street 2:
Practice Address - City:STONE RIDGE
Practice Address - State:VA
Practice Address - Zip Code:20105-5686
Practice Address - Country:US
Practice Address - Phone:703-810-5241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-06
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist