Provider Demographics
NPI:1932965597
Name:BRIGGS, THIPPAWAN
Entity Type:Individual
Prefix:MRS
First Name:THIPPAWAN
Middle Name:
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:MR
Other - First Name:THIPPAWAN
Other - Middle Name:
Other - Last Name:PANDEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14622 BATTERY RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-2884
Mailing Address - Country:US
Mailing Address - Phone:202-695-9624
Mailing Address - Fax:
Practice Address - Street 1:14622 BATTERY RIDGE LN
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-2884
Practice Address - Country:US
Practice Address - Phone:202-695-9624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMT2000001342225700000X
VA0019017850225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist