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Organization

PEDIATRIC THERAPY STUDIO

Active
Other names
Great Beginnings VA
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LINDA HALIM (CLINICAL MANAGER)
(703) 638-3056
Entity
Organization

Contact information

Practice address
8227 OLD - COURTHOUSE RD #115, VIENNA, VA 22182
(703) 663-4808
(703) 665-1241
Mailing address
8221 OLD COURTHOUSE RD, SUITE 105, VIENNA, VA 22182-3839
(703) 663-4808
(844) 764-4499

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist
2202006160
VA
235Z00000X
Speech-Language Pathologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1568778587
VA
Enumeration date
10/29/2013
Last updated
05/16/2022
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