Provider Demographics
NPI:1831330703
Name:RADLEY, LAUREL CARGILL (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:CARGILL
Last Name:RADLEY
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 1:3701 R ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2123
Mailing Address - Country:US
Mailing Address - Phone:202-333-7533
Mailing Address - Fax:
Practice Address - Street 1:5165 11TH ST S
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-3231
Practice Address - Country:US
Practice Address - Phone:703-933-0297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT893174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist