Healthcare Provider Details

I. General information

NPI: 1457287682
Provider Name (Legal Business Name): DIANA BOZZAY OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANA ROLLAND OTD

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

362 CHRISTOPHER AVE STE A
GAITHERSBURG MD
20879-3613
US

IV. Provider business mailing address

18876 LOUDOUN ORCHARD RD
LEESBURG VA
20175-6855
US

V. Phone/Fax

Practice location:
  • Phone: 703-727-9884
  • Fax:
Mailing address:
  • Phone: 703-727-9884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number10780
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119011445
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: