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General NPI Number Information
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NPI Number | 1831747575
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Entity Type | Individual
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Provider Name | JESSE MARIE ACIERTO
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Gender | Female
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Dates
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Enumeration Date | 08/27/2019
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 5980 RADIO STATION RD
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City | LA PLATA
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State | MD
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Zip | 20646-3337
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Country | US
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Telephone | 301-934-7432
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2770
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City | LA PLATA
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State | MD
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Zip | 20646-2770
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Country | US
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Telephone | 703-859-1328
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 09707
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License Number State | MD
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