Provider Demographics
NPI:1205342110
Name:HAMILTON, ROCHELLE LYNN (OTR/L ATP)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:LYNN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:OTR/L ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 EBENEZER CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-3819
Mailing Address - Country:US
Mailing Address - Phone:703-402-4959
Mailing Address - Fax:
Practice Address - Street 1:14715 BRISTOW RD
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20112-3945
Practice Address - Country:US
Practice Address - Phone:703-791-7282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-15
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119001095225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist