Healthcare Provider Details

I. General information

NPI: 1720372923
Provider Name (Legal Business Name): SUSAN STOWERS CLEARY MS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2011
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 WASHINGTON BLVD
ARLINGTON VA
22204-5719
US

IV. Provider business mailing address

2110 WASHINGTON BLVD
ARLINGTON VA
22204-5719
US

V. Phone/Fax

Practice location:
  • Phone: 703-750-2443
  • Fax:
Mailing address:
  • Phone: 703-228-2685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number0119002443
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: