Healthcare Provider Details

I. General information

NPI: 1962090381
Provider Name (Legal Business Name): ICAN OT, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2021
Last Update Date: 02/28/2023
Certification Date: 02/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 N BELGRADE RD
SILVER SPRING MD
20902-3024
US

IV. Provider business mailing address

1208 N BELGRADE RD
SILVER SPRING MD
20902-3024
US

V. Phone/Fax

Practice location:
  • Phone: 301-928-2407
  • Fax:
Mailing address:
  • Phone: 301-928-2407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHAL MERKIN
Title or Position: OCCUPATIONAL THERAPIST
Credential: MS, OT, R/L
Phone: 301-928-2407