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NPI Code Detail

MEDICARE: MRS. STACEY C LUMPKIN O.T.

MEDICARE: MRS. STACEY C LUMPKIN O.T.
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 Therapist02896MD

General Provider Information

NPI Number : 1275854218
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STACEY C LUMPKIN O.T.
Provider Business Mailing Address
First Line : 12 MEDSTAR BLVD STE 325
Second Line :
City : BEL AIR
State : MD
Zip : 21015-1817
Country : US
Telephone Number : 410-877-8078
Fax Number : 410-877-8079
Provider Business Practice Location Address
First Line : 12 MEDSTAR BLVD STE 325
Second Line :
City : BEL AIR
State : MD
Zip : 21015-1817
Country : US
Telephone Number : 410-877-8078
Fax Number : 410-877-8079
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2010
Last Update Date : 12/14/2023

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