Provider Demographics
NPI:1215191473
Name:WAINLESS, LILIANA (PT)
Entity type:Individual
Prefix:MRS
First Name:LILIANA
Middle Name:
Last Name:WAINLESS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8149 RIDGE CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-1934
Mailing Address - Country:US
Mailing Address - Phone:703-866-2464
Mailing Address - Fax:
Practice Address - Street 1:8149 RIDGE CREEK WAY
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22153-1934
Practice Address - Country:US
Practice Address - Phone:703-866-2464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305003614225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist