Phongphan Roach
Occupational Therapist - Physical Rehabilitation
2980 Centreville Rd
Herndon
, Virginia 20171-6254
Phongphan Roach
Occupational Therapist - Physical Rehabilitation
2980 Centreville Rd
Herndon
, Virginia 20171-6254
(916) 450-1203
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About
Features
Specialties
- Occupational Therapist - Physical Rehabilitation
Languages spoken
- English
Location
First Address
- Phongphan Roach
- 1912 Villaridge Dr Unit B
- Reston, VA
- Zip : 20191-4830
- Phone : (916) 450-1203
Second Address
- Phongphan Roach
- 2980 Centreville Rd
- Herndon, VA
- Zip : 20171-6254
- Phone : (703) 994-4561
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 0131001567 | VA |
National Provider Identifier
| NPI | 1326558925 |
|---|---|
| Provider Name | Phongphan Roach |
| First Address | Reston, VA 20191-4830 |
| Second Address | Herndon, VA 20171-6254 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/10/2017 |
| Last Update Date | 09/10/2017 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.