Provider Demographics
NPI:1245661248
Name:TROXELL, HEATHER KATHRYN
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:KATHRYN
Last Name:TROXELL
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 1:18290 TUPELO RIDGE TER
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-6826
Mailing Address - Country:US
Mailing Address - Phone:703-777-8700
Mailing Address - Fax:
Practice Address - Street 1:18290 TUPELO RIDGE TER
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-6826
Practice Address - Country:US
Practice Address - Phone:703-777-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119005531225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist