Healthcare Provider Details

I. General information

NPI: 1326452798
Provider Name (Legal Business Name): CHRISTIANA SANTOS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTIANA RUECKERT OTR/L

II. Dates (important events)

Enumeration Date: 06/13/2014
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W BROAD ST STE 405
FALLS CHURCH VA
22046-3203
US

IV. Provider business mailing address

701 W BROAD ST STE 405
FALLS CHURCH VA
22046-3203
US

V. Phone/Fax

Practice location:
  • Phone: 540-227-0268
  • Fax: 540-339-7137
Mailing address:
  • Phone: 571-730-7195
  • Fax: 540-339-7137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number0119006317
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119006317
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: