Healthcare Provider Details

I. General information

NPI: 1003302357
Provider Name (Legal Business Name): RAHNA CUSICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2018
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 MONTEVUE LN
FREDERICK MD
21702-8214
US

IV. Provider business mailing address

13696 LEXINGTON DR # 21771
MOUNT AIRY MD
21771-5813
US

V. Phone/Fax

Practice location:
  • Phone: 301-600-1029
  • Fax:
Mailing address:
  • Phone: 410-292-7018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberT01178
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: