Taryn Nichelle Pettigrew, OT

NPI #1679296594 in Lake Ridge, Virginia

Provider Information

NPI Number: 1679296594
Entity Type: Individual
Name: Taryn Nichelle Pettigrew, OT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Occupational Therapist
Credential: OT
Enumeration Date: Sep 26, 2022
Last Updated: Feb 13, 2023

Practice Location

Address: 12185 CLIPPER DR
City: Lake Ridge
State: Virginia
ZIP Code: 22192-2236
Phone: (703) 457-8648

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary
Occupational Therapist - Pediatrics — Pediatrics	225XP0200X

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