Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | DC | |
Y | 2251N0400X | Physical Therapist - Neurology | PT 2305207331 | VA |
NPI | 1225267552 |
---|---|
Provider Name | Dr. Jade Jasmine Bender-Burnett |
First Address | Springfield, VA 22151-1606 |
Second Address | Springfield, VA 22151-1606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2009 |
Last Update Date | 19/11/2015 |