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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

ETHAN LANE CARROLL

Active

ETHAN LANE CARROLL is a Occupational Therapist healthcare provider located in MC LEAN, Virginia. NPI 1548855141 is currently active in the NPPES registry. Verify at CMS.

Occupational Therapist · MC LEAN, VA

Registration Details

NPI Number
1548855141
Provider Type
Individual
Gender
Male
NPI Issued
Mar 4, 2021 (5.4389210129203 yrs)
Last Updated
Mar 4, 2021
License
2306605698 (VA)

Practice Information

Address
6858 OLD DOMINION DR STE 200
MC LEAN, VA, 221013832
Browse VA providers · Browse ZIP 22101
Phone
7032888260
Primary Specialty
Occupational Therapist
225200000X

Other Occupational Therapist Providers in MC LEAN, VA

Name Credential NPI
BUKUNOLA CAILLIER 1285067785
MR. JOHN BULT LPTA 1811371156
ROBERT FITZGERALD PEREDDO LPTA 1457833766
MS. MERSAL ZAMAN 1194498923
JUSTIN MEADE GRIGGS 1720714934
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.