Healthcare Provider Details

I. General information

NPI: 1588577282
Provider Name (Legal Business Name): GRACE CELVA LAWTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 STAFFORD AVE
STAFFORD VA
22554-7246
US

IV. Provider business mailing address

8721 PARLIAMENT DR
SPRINGFIELD VA
22151-1224
US

V. Phone/Fax

Practice location:
  • Phone: 540-658-6000
  • Fax:
Mailing address:
  • Phone: 571-296-3155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number0119011522
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: