Provider Demographics
NPI:1720621089
Name:HALSTEAD, ANNE-MARIE ROSE (OTR/L)
Entity type:Individual
Prefix:
First Name:ANNE-MARIE
Middle Name:ROSE
Last Name:HALSTEAD
Suffix:
Gender:
Credentials:OTR/L
Other - Prefix:
Other - First Name:ANNE-MARIE
Other - Middle Name:ROSE
Other - Last Name:HANCOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:302 COVE POINT TRAIL
Mailing Address - Street 2:
Mailing Address - City:MONETA
Mailing Address - State:VA
Mailing Address - Zip Code:24121-3700
Mailing Address - Country:US
Mailing Address - Phone:434-420-0528
Mailing Address - Fax:
Practice Address - Street 1:3925 DOWNS DR
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-3308
Practice Address - Country:US
Practice Address - Phone:877-407-3422
Practice Address - Fax:877-407-4329
Is Sole Proprietor?:No
Enumeration Date:2019-10-18
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2081225X00000X
VA0119008280225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist