Healthcare Provider Details

I. General information

NPI: 1992476121
Provider Name (Legal Business Name): EMILY GUZEWICH OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2021
Last Update Date: 02/09/2022
Certification Date: 02/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9642 BURKE LAKE RD STE 1
BURKE VA
22015-3024
US

IV. Provider business mailing address

373 N GLEBE RD APT 4
ARLINGTON VA
22203-3318
US

V. Phone/Fax

Practice location:
  • Phone: 703-425-1698
  • Fax:
Mailing address:
  • Phone: 315-985-5345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119-009247
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: