Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 2305006600 | VA |
NPI | 1043281652 |
---|---|
Provider Name | Mrs. Jennifer W Herrington |
First Address | Alexandria, VA 22309-2585 |
Second Address | Alexandria, VA 22309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2006 |
Last Update Date | 01/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2305006600 | VA LICENSE (01) | VA |