Individual
MRS. JENNIFER M MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
24689 KINGS CANYON SQ, STONE RIDGE, VA 20105-2988
(703) 327-9458
Mailing address
24689 KINGS CANYON SQ, STONE RIDGE, VA 20105-2988
(703) 963-1514
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119001129
VA
225XG0600X
Gerontology Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
0119001129
VA
Other
Enumeration date
01/20/2009
Last updated
07/10/2014
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