Healthcare Provider Details

I. General information

NPI: 1265989065
Provider Name (Legal Business Name): LAINIE KRAMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2016
Last Update Date: 09/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3508 LEE HWY
ARLINGTON VA
22207-3717
US

IV. Provider business mailing address

1200 N GARFIELD ST APT 823
ARLINGTON VA
22201-6816
US

V. Phone/Fax

Practice location:
  • Phone: 703-243-4601
  • Fax:
Mailing address:
  • Phone: 301-928-2088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number0119006998
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT010001189
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: