MEDICARE: I ADAPT OT, LLC

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
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1508571282
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	I ADAPT OT, LLC

Provider Business Mailing Address
First Line	:	6055 CEDAR WOOD DR
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-3674
Country	:	US
Telephone Number	:	410-650-6885
Fax Number	:	410-650-6886

Provider Business Practice Location Address
First Line	:	6055 CEDAR WOOD DR
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-3674
Country	:	US
Telephone Number	:	410-650-6885
Fax Number	:	410-650-6886

Authorized Official
Title or Position	:	OWNER, OCCUPATIONAL THERAPIST
Name	:	MRS. MARIE ELIZABETH LOUGHLIN DIXON
Credential	:	OT
Telephone Number	:	410-650-6885

Provider Enumeration Date	:	01/18/2023
Last Update Date	:	01/18/2023

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