Healthcare Provider Details

I. General information

NPI: 1467863746
Provider Name (Legal Business Name): JESSICA ALDEN OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 06/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOWARD UNIVERSITY BRYANT STREET
WASHINGTON DC
20059-0001
US

IV. Provider business mailing address

5303 CONNECTICUT AVE NW
WASHINGTON DC
20015-1803
US

V. Phone/Fax

Practice location:
  • Phone: 202-696-0516
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT010000583
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License NumberOT010000583
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License NumberOT010000583
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code225XR0403X
TaxonomyDriving and Community Mobility Occupational Therapist
License NumberOT010000583
License Number StateDC
# 5
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT010000583
License Number StateDC
# 6
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License NumberOT010000583
License Number StateDC
# 7
Primary TaxonomyN
Taxonomy Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License NumberOT010000583
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: