# PEDIATRIC THERAPY STUDIO

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Great Beginnings VA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992133037
- **Authorized official:** MRS. LINDA HALIM (CLINICAL MANAGER)
- **Authorized official phone:** (703) 638-3056

## Contact information

- **Practice address:** 8227 OLD - COURTHOUSE RD \#115, VIENNA, VA 22182
- **Practice address phone:** (703) 663-4808
- **Practice address fax:** (703) 665-1241
- **Mailing address:** 8221 OLD COURTHOUSE RD, SUITE 105, VIENNA, VA 22182-3839
- **Mailing address phone:** (703) 663-4808
- **Mailing address fax:** (844) 764-4499

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | — | — | Yes |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | 2202006160 | VA | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 10/29/2013
- **Last updated:** 05/16/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1568778587 | — | VA |