Individual
KIANA GAETANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6715 LITTLE RIVER TPKE STE 200, ANNANDALE, VA 22003-3546
(703) 879-2479
Mailing address
2600 CRYSTAL DR APT 624, ARLINGTON, VA 22202-3570
(724) 719-1851
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6202
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119010774
VIRGINIA OCCUPATIONAL THERAPY LICENSE
VA
01
—
10246
MARYLAND OCCUPATIONAL THERAPY LICENSE
MD
05
—
9000195060
—
CO
Enumeration date
11/05/2020
Last updated
01/28/2025
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