Healthcare Provider Details

I. General information

NPI: 1619485539
Provider Name (Legal Business Name): ROXANNE WILLIAMS RICHARDSON VISION TEACHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2018
Last Update Date: 01/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8757 GEORGIA AVE
SILVER SPRING MD
20910-3737
US

IV. Provider business mailing address

8757 GEORGIA AVE
SILVER SPRING MD
20910-3737
US

V. Phone/Fax

Practice location:
  • Phone: 240-737-5100
  • Fax: 240-737-5100
Mailing address:
  • Phone: 240-737-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255R0406X
TaxonomyBlind Rehabilitation Specialist/Technologist
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: