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General NPI Number Information
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NPI Number | 1275971871
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Entity Type | Individual
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Provider Name | MARILEE SELLERS PAZICKY P.T., M.P.T.
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Gender | Female
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Dates
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Enumeration Date | 06/05/2013
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Last Update Date | 11/09/2015
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Provider Practice Location Address
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Address Line | 16505 GRANDE VISTA DR
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City | DERWOOD
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State | MD
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Zip | 20855-1917
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Country | US
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Telephone | 240-686-5840
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Fax |
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Provider Business Mailing Address
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Address Line | 16505 GRANDE VISTA DR
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City | DERWOOD
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State | MD
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Zip | 20855-1917
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT014031L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 18630
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License Number State | MD
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