Provider Demographics
NPI:1376132100
Name:SUAREZ, JOCELYN BRENDA (OTR/L)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:BRENDA
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JOCELYN
Other - Middle Name:BRENDA
Other - Last Name:SUAREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5632 MOUNT BURNSIDE WAY
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-2143
Mailing Address - Country:US
Mailing Address - Phone:703-554-0120
Mailing Address - Fax:
Practice Address - Street 1:5009 WHISPER WILLOW DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-8205
Practice Address - Country:US
Practice Address - Phone:571-251-1208
Practice Address - Fax:703-543-2340
Is Sole Proprietor?:No
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist