Healthcare Provider Details

I. General information

NPI: 1861867137
Provider Name (Legal Business Name): CASSANDRA NOELLE GARCIA M.S., OTR/L, BCP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2015
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7617 LITTLE RIVER TPKE SUITE 310
ANNANDALE VA
22003-2603
US

IV. Provider business mailing address

7617 LITTLE RIVER TPKE SUITE 310
ANNANDALE VA
22003-2603
US

V. Phone/Fax

Practice location:
  • Phone: 703-941-7757
  • Fax: 703-941-0587
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119006795
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: