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General NPI Number Information
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NPI Number | 1053805226
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Entity Type | Individual
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Provider Name | TARA ALESE DAWKINS PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 6862 ELM ST STE 105
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City | MC LEAN
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State | VA
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Zip | 22101-3862
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Country | US
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Telephone | 703-556-7788
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Fax |
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Provider Business Mailing Address
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Address Line | 6862 ELM ST STE 105
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City | MC LEAN
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State | VA
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Zip | 22101-3862
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Country | US
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Telephone | 405-473-0412
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305216132
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License Number State | VA
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