Individual
CHRISTY MALLORY CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, OTR/L
Contact information
Practice address
6521 ARLINGTON BLVD, SUITE 312, FALLS CHURCH, VA 22042-3016
(703) 536-1817
Mailing address
6521 ARLINGTON BLVD, SUITE 312, FALLS CHURCH, VA 22042-3016
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0119005461
VA
225XP0200X
Pediatric Occupational Therapist
OT010000742
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12615461
CAQH
—
Enumeration date
02/12/2013
Last updated
11/26/2013
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