Healthcare Provider Details

I. General information

NPI: 1609049477
Provider Name (Legal Business Name): TOTS TO TEENS THERAPY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2008
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12581 MILSTEAD WAY SUITE 302
WOODBRIDGE VA
22192
US

IV. Provider business mailing address

12263 CHARLES LACEY DR.
MANASSAS VA
20112
US

V. Phone/Fax

Practice location:
  • Phone: 703-239-7336
  • Fax: 719-375-3116
Mailing address:
  • Phone: 703-507-1533
  • Fax: 719-375-3116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. JENNIFER DUNCAN RUCKNER
Title or Position: OWNER/PRESIDENT
Credential: MS CCC-SLP
Phone: 703-507-1533