Individual
JACQUELINE WADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
14715 BRISTOW RD, MANASSAS, VA 20112-3945
(703) 792-7282
Mailing address
8621 ETTA DR, SPRINGFIELD, VA 22152-2706
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119003738
VA
Other
Enumeration date
12/20/2017
Last updated
12/20/2017
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