Healthcare Provider Details

I. General information

NPI: 1124786140
Provider Name (Legal Business Name): RACHEL DAILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2021
Last Update Date: 12/07/2021
Certification Date: 12/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2978 CENTREVILLE RD
HERNDON VA
20171-6253
US

IV. Provider business mailing address

660 N LOUDOUN ST APT 3
WINCHESTER VA
22601-4986
US

V. Phone/Fax

Practice location:
  • Phone: 703-934-5000
  • Fax:
Mailing address:
  • Phone: 304-240-7437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2306603724
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: