Healthcare Provider Details

I. General information

NPI: 1851832372
Provider Name (Legal Business Name): DIANNE BRAUN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANNE MARIE SMITH PT

II. Dates (important events)

Enumeration Date: 03/16/2017
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 IRVING ST NW
WASHINGTON DC
20010-2921
US

IV. Provider business mailing address

6241 MARTIN RD
COLUMBIA MD
21044-3946
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-1000
  • Fax:
Mailing address:
  • Phone: 410-608-9751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number17302
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number872093
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: