Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Taryn Nichelle Pettigrew, OT

Individual provider Pediatric Occupational Therapist · NPI 1679296594

Taryn Nichelle Pettigrew, OT is a Pediatric Occupational Therapist in Lake Ridge, Virginia. Practices as a sole proprietor. Licensed in Pennsylvania and Virginia.

Licensed in
PA, VA
In the registry since
2022
Specialties on file
2
What do these letters mean?
OT — Occupational Therapist
Helps people regain the skills needed for daily living and work.

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Practice location Address checks out

4004 Genesee Pl Ste 209
Lake Ridge, VA 22192-8305
Phone: (703) 457-8648
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 0119009818 (VA)
Pediatric Occupational Therapist Taxonomy 225XP0200X · Licence OC018708 (PA)

Record details

NPI number1679296594
Entity typeIndividual (Type 1)
GenderFemale
Credentials OT
Sole proprietorYes
NPI enumeratedSeptember 26, 2022
Last updated in NPPESJuly 31, 2026
Certification dateJuly 31, 2026

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