Basic Information
Provider Information
NPI: 1568737955
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAJER
FirstName: ASHLEY
MiddleName: MICHELLE
NamePrefix:  
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
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Mailing Information
Address1: 11240 WAPLES MILL RD
Address2: SUITE 403
City: FAIRFAX
State: VA
PostalCode: 220306078
CountryCode: US
TelephoneNumber: 7033836454
FaxNumber: 7038105494
Practice Location
Address1: 3620 JOSEPH SIEWICK DR
Address2: SUITE 100-A
City: FAIRFAX
State: VA
PostalCode: 220331756
CountryCode: US
TelephoneNumber: 7038105227
FaxNumber: 7038105494
Other Information
ProviderEnumerationDate: 03/19/2012
LastUpdateDate: 10/28/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/28/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X0119005545VAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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