Healthcare Provider Details

I. General information

NPI: 1346918810
Provider Name (Legal Business Name): ALLISON KOPS DPT, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON WEBBER

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6011 WOODLAKE LN
ALEXANDRIA VA
22315-2638
US

IV. Provider business mailing address

6011 WOODLAKE LN
ALEXANDRIA VA
22315-2638
US

V. Phone/Fax

Practice location:
  • Phone: 571-483-8332
  • Fax:
Mailing address:
  • Phone: 703-436-9009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number2305212966
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-315580
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: