Healthcare Provider Details

I. General information

NPI: 1720863061
Provider Name (Legal Business Name): EMILY DAWN UNGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2023
Last Update Date: 08/25/2023
Certification Date: 08/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5910 WILSON BLVD
ARLINGTON VA
22205-1554
US

IV. Provider business mailing address

1309 SHADY OAK DR
CARSON CITY NV
89701-5738
US

V. Phone/Fax

Practice location:
  • Phone: 703-536-1060
  • Fax:
Mailing address:
  • Phone: 240-310-4806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License NumberO119009968
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: