Provider Demographics
NPI:1720634785
Name:LANDY, JENNIFER (MS, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:LANDY
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7617 LITTLE RIVER TPKE STE 310
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2603
Mailing Address - Country:US
Mailing Address - Phone:703-941-7757
Mailing Address - Fax:
Practice Address - Street 1:7617 LITTLE RIVER TPKE STE 310
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2603
Practice Address - Country:US
Practice Address - Phone:703-941-7757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty