Healthcare Provider Details

I. General information

NPI: 1144152588
Provider Name (Legal Business Name): NANCY LODGE DOODY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21631 RIDGETOP CIR STE 225
STERLING VA
20166-4289
US

IV. Provider business mailing address

56 E BROAD WAY
LOVETTSVILLE VA
20180-8607
US

V. Phone/Fax

Practice location:
  • Phone: 571-207-8850
  • Fax:
Mailing address:
  • Phone: 540-550-1597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119011415
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: