Individual
KRISTIN MARIE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2110 WASHINGTON BLVD STE. 158, ARLINGTON, VA 22204
(202) 427-8290
Mailing address
2110 WASHINGTON BLVD STE. 158, ARLINGTON, VA 22204
(202) 427-8290
Taxonomy
Speciality
Code
Description
License number
State
225XH1300X
Human Factors Occupational Therapist
010000508
DC
225XH1300X
Human Factors Occupational Therapist
0119004399
VA
225XH1300X
Human Factors Occupational Therapist
220439
OR
225XH1300X
Human Factors Occupational Therapist
Primary
2758
NM
Other
Enumeration date
01/27/2011
Last updated
01/30/2019
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