=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760748776
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEREDITH K GRIGSBY OTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2012
-----------------------------------------------------
Last Update Date | 04/03/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 110 IRVING ST NW
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20010-3017
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-877-7000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1700 BEARDS CREEK CT
-----------------------------------------------------
City | DAVIDSONVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21035-2034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-903-0264
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OT010000713
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------