Provider Demographics
NPI:1841060761
Name:CICHON, ALYSSA JOY (OTD)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:JOY
Last Name:CICHON
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:JOY
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:625 E MONROE AVE APT 206
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22301-3023
Mailing Address - Country:US
Mailing Address - Phone:616-822-8804
Mailing Address - Fax:
Practice Address - Street 1:15850 CRABBS BRANCH WAY STE 150
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20855-2622
Practice Address - Country:US
Practice Address - Phone:301-869-7505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10136225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics