Provider Demographics
NPI:1427127125
Name:HENRICH, IRENE JOYCE (PT)
Entity type:Individual
Prefix:MRS
First Name:IRENE
Middle Name:JOYCE
Last Name:HENRICH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:IRENE
Other - Middle Name:JOYCE
Other - Last Name:MCGEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:5718 EVERGREEN KNOLL CT
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22303-1052
Mailing Address - Country:US
Mailing Address - Phone:804-306-1366
Mailing Address - Fax:
Practice Address - Street 1:3440 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-3145
Practice Address - Country:US
Practice Address - Phone:703-578-7662
Practice Address - Fax:703-578-7129
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305005891225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist