Provider Demographics
NPI:1689402240
Name:PINEDA, ARIANA (COTA, PTA)
Entity type:Individual
Prefix:
First Name:ARIANA
Middle Name:
Last Name:PINEDA
Suffix:
Gender:F
Credentials:COTA, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5142 MASON PARK DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24019-2722
Mailing Address - Country:US
Mailing Address - Phone:540-397-9355
Mailing Address - Fax:
Practice Address - Street 1:4355 PHEASANT RIDGE RD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-5272
Practice Address - Country:US
Practice Address - Phone:540-725-8210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131002793224Z00000X
VA2306606585225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant