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NPI Code Detail

MEDICARE: AMANDA RICHARDSON

MEDICARE: AMANDA RICHARDSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1679419444
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA RICHARDSON
Provider Business Mailing Address
First Line : 5695 KING CENTRE DR STE 100
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22315-5745
Country : US
Telephone Number : 571-303-1298
Fax Number :
Provider Business Practice Location Address
First Line : 5695 KING CENTRE DR STE 100
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22315-5745
Country : US
Telephone Number : 571-303-1298
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2026
Last Update Date : 04/24/2026

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Directions to “ AMANDA RICHARDSON ” Practice Location

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