Provider Demographics
NPI:1871475962
Name:ROEGGE, CHANDLER TYRRELL (MSOT, OTR/L)
Entity type:Individual
Prefix:
First Name:CHANDLER
Middle Name:TYRRELL
Last Name:ROEGGE
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:CHANDLER
Other - Middle Name:ANNE
Other - Last Name:TYRRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOT, OTR/L
Mailing Address - Street 1:3020 HAMAKER CT STE 100
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2233
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3020 HAMAKER CT STE 100
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2233
Practice Address - Country:US
Practice Address - Phone:703-844-8599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119007262225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation