Healthcare Provider Details

I. General information

NPI: 1972400133
Provider Name (Legal Business Name): NICOLE DANIELLE DAOUST OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2026
Last Update Date: 10/21/2026
Certification Date: 10/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PENNSYLVANIA AVE SE
WASHINGTON DC
20003-3027
US

IV. Provider business mailing address

1301 PENNSYLVANIA AVE SE
WASHINGTON DC
20003-3027
US

V. Phone/Fax

Practice location:
  • Phone: 202-335-7968
  • Fax: 202-379-1797
Mailing address:
  • Phone: 202-335-7968
  • Fax: 202-379-1797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number0119011654
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: