Individual
JENNIFER FAHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
2235 TACKETTS MILL DR, SUITE C, WOODBRIDGE, VA 22192-3036
(703) 491-1044
(703) 491-2044
Mailing address
2235 TACKETTS MILL DR, SUITE C, WOODBRIDGE, VA 22192-3036
(703) 491-1044
(703) 491-2044
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119006741
VA
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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