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Miss Jackalyn Nicole Peterson, DPT
Specialist in Fairfax, Virginia
NPI 1013241769

Jackalyn Nicole Peterson is a Specialist based in Fairfax, VA. Jackalyn Nicole Peterson practices in Fairfax, VA and has the professional credentials of DPT. The NPI Number for Jackalyn Nicole Peterson is 1013241769 and holds a License No. 2305206191 (Virginia).

The current practice location address for Jackalyn Nicole Peterson is 9860 Fairfax Blvd, Fairfax, VA and can be reached out via phone at 703-383-1616 and via fax at 703-383-1166.

Location: 9860 Fairfax Blvd, Fairfax, VA, 22030-1737
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1013241769
Provider Name
Jackalyn Nicole Peterson
Credential
DPT
Provider Entity Type
Individual
Gender
Female
Address
9860 Fairfax Blvd, Fairfax, VA, 22030-1737
Phone Number
703-383-1616
Fax Number
703-383-1166
Provider Enumeration Date
09/29/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
9860 Fairfax Blvd
City
Fairfax
State
Virginia
Zip
22030-1737
Phone Number
703-383-1616
Fax Number
703-383-1166
person
Provider Business Mailing Address Details
Address
9860 Fairfax Blvd
City
Fairfax
State
Virginia
Zip
22030-1737
Phone Number
703-383-1616
Fax Number
703-383-1166
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
2305206191 (Virginia)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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