Provider Demographics
NPI:1487880969
Name:GUILLIANO, SANDRA SAGLE (PT)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:SAGLE
Last Name:GUILLIANO
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 1:20524 LANSING TER
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5133
Mailing Address - Country:US
Mailing Address - Phone:703-310-6976
Mailing Address - Fax:703-724-4320
Practice Address - Street 1:20098 ASHBROOK PL
Practice Address - Street 2:SUITE 190
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-3393
Practice Address - Country:US
Practice Address - Phone:703-723-5225
Practice Address - Fax:703-723-5595
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305006465225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist