Provider Demographics
NPI:1598703068
Name:WALLSCHLAEGER, NAJWA J (OTRL)
Entity type:Individual
Prefix:
First Name:NAJWA
Middle Name:J
Last Name:WALLSCHLAEGER
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:NAJWA
Other - Middle Name:
Other - Last Name:JARJOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:PO BOX 715868
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19171-5868
Mailing Address - Country:US
Mailing Address - Phone:804-915-1910
Mailing Address - Fax:804-968-1803
Practice Address - Street 1:1760 OLD MEADOW RD STE 205
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-4330
Practice Address - Country:US
Practice Address - Phone:703-810-5214
Practice Address - Fax:703-810-5475
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119001939225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1598703068Medicaid
00W355O06Medicare PIN
Q25713Medicare UPIN
P01584737Medicare PIN
Q51890AMedicare PIN