Taryn Nichelle Pettigrew, OT - Occupational Therapist in Lake Ridge, VA

Taryn Nichelle Pettigrew, OT is a Occupational Therapist based in Lake Ridge, Virginia. Taryn Nichelle Pettigrew is licensed to practice in Virginia (license number 0119009818) and her current practice location is 12185 Clipper Dr, Lake Ridge, Virginia. She can be reached at her office (for appointments etc.) via phone at (703) 457-8648.

NPI number for Taryn Nichelle Pettigrew is 1679296594 and her current mailing address is 15061 Galapagos Pl, Woodbridge, Virginia. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1679296594.

Contact Information

Taryn Nichelle Pettigrew, OT
12185 Clipper Dr,
Lake Ridge, VA 22192-2236
(703) 457-8648
Not Available



Healthcare Provider's Profile

Full NameTaryn Nichelle Pettigrew
GenderFemale
SpecialityOccupational Therapist
Location12185 Clipper Dr, Lake Ridge, Virginia
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1679296594
  • Provider Enumeration Date: 09/26/2022
  • Last Update Date: 02/13/2023

Medical Identifiers

Medical identifiers for Taryn Nichelle Pettigrew such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1679296594NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225X00000XOccupational Therapist 0119009818 (Virginia)Primary
225XP0200XOccupational Therapist - Pediatrics OC018708 (Pennsylvania)Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Taryn Nichelle Pettigrew is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Taryn Nichelle Pettigrew, OT
15061 Galapagos Pl,
Woodbridge, VA 22193-5842

Ph: (703) 875-1489
Taryn Nichelle Pettigrew, OT
12185 Clipper Dr,
Lake Ridge, VA 22192-2236

Ph: (703) 457-8648

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› Verified 9 days ago


Occupational Therapist in Lake Ridge, VA

Ms. Logan Denise Luke, OTR/L
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 12191 Clipper Dr, Lake Ridge, VA 22192
Phone: 703-457-8648    
Kayla Sharma,
Occupational Therapist
Medicare: Medicare Enrolled
Practice Location: 12825 Minnieville Rd Ste 201, Lake Ridge, VA 22192
Phone: 703-647-3130    

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