Healthcare Provider Details

I. General information

NPI: 1215840269
Provider Name (Legal Business Name): RISE AND THRIVE THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13129 PELFREY LN
FAIRFAX VA
22033-3029
US

IV. Provider business mailing address

13129 PELFREY LN
FAIRFAX VA
22033-3029
US

V. Phone/Fax

Practice location:
  • Phone: 410-241-4159
  • Fax:
Mailing address:
  • Phone: 410-241-4159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: KELLY REBEKAH HILTZ
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 410-241-4159