Healthcare Provider Details

I. General information

NPI: 1245102250
Provider Name (Legal Business Name): GEORGIA PHILBIN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

8402 RIVER ROCK TER
BETHESDA MD
20817-4301
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: