Individual
KELLY PENNOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1739 KIRBY RD, MC LEAN, VA 22101-4817
(800) 451-5121
Mailing address
2238 WHITCOMB PL, FALLS CHURCH, VA 22046-1852
(540) 840-2247
(540) 840-2247
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
VA
Other
Enumeration date
01/17/2018
Last updated
01/17/2018
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