Healthcare Provider Details

I. General information

NPI: 1184197469
Provider Name (Legal Business Name): MRS. SYBIL K. YAVER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2019
Last Update Date: 01/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MCPS PHYSICAL DISABILITIES PROGRAM 8001 LYNNBROOK DRIVE
BETHESDA MD
20814
US

IV. Provider business mailing address

850 HUNGERFORD DR
ROCKVILLE MD
20850-1718
US

V. Phone/Fax

Practice location:
  • Phone: 240-740-5500
  • Fax:
Mailing address:
  • Phone: 240-740-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number02252
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: