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NPI Code Detail

MEDICARE: JAVONNA FERGUSON

MEDICARE: JAVONNA FERGUSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist07267MD

General Provider Information

NPI Number : 1275067159
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAVONNA FERGUSON
Provider Business Mailing Address
First Line : 9511 WHITEHURST DR
Second Line :
City : OWINGS MILLS
State : MD
Zip : 21117-4742
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9511 WHITEHURST DR
Second Line :
City : OWINGS MILLS
State : MD
Zip : 21117-4742
Country : US
Telephone Number : 410-356-3246
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2017
Last Update Date : 04/17/2017

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Directions to “ JAVONNA FERGUSON ” Practice Location

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