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General NPI Number Information
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NPI Number | 1053367920
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Entity Type | Individual
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Provider Name | TRACY CAPILI OTR
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Gender | Female
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 11/06/2012
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Provider Practice Location Address
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Address Line | 13854 SMOKETOWN RD
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City | WOODBRIDGE
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State | VA
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Zip | 22192-4210
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Country | US
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Telephone | 703-670-9935
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Fax | 703-670-9939
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Provider Business Mailing Address
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Address Line | 8316 ARLINGTON BLVD SUITE 400
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City | FAIRFAX
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State | VA
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Zip | 22031-5207
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Country | US
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Telephone | 703-560-3190
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Fax | 703-560-3194
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 5122
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0119005662
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License Number State | VA
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