Provider Demographics
NPI:1134558836
Name:CHESAPEAKE CHILDREN'S THERAPY CENTER
Entity type:Organization
Organization Name:CHESAPEAKE CHILDREN'S THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PRACTICES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PREETEE
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGHAL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:703-924-4171
Mailing Address - Street 1:6506 LOISDALE RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-1824
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6506 LOISDALE RD
Practice Address - Street 2:SUITE 302
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-1824
Practice Address - Country:US
Practice Address - Phone:703-924-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119006121225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty