Individual
LEANNE NICOLE BRYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
8270 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4511
(571) 423-4864
Mailing address
8270 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4511
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119003924
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4980701
—
VA
Enumeration date
07/26/2006
Last updated
03/17/2018
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