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General NPI Number Information
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NPI Number | 1124270616
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Entity Type | Individual
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Provider Name | LAUREN BETH STARACE
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Gender | Female
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 07/05/2016
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Provider Practice Location Address
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Address Line | 44927 GEORGE WASHINGTON BLVD #210
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City | ASHBURN
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State | VA
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Zip | 20147-4295
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Country | US
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Telephone | 571-291-9936
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Fax |
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Provider Business Mailing Address
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Address Line | 44927 GEORGE WASHINGTON BLVD #210
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City | ASHBURN
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State | VA
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Zip | 20147-4295
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Country | US
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Telephone |
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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 | 18432
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01215900
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT36159
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 2305206813
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305206813
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License Number State | VA
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