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General NPI Number Information
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NPI Number | 1841709771
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Entity Type | Organization
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Legal Business Name | PECAR PEDIATRIC THERAPY LLC
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Dates
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Enumeration Date | 09/22/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1423 1ST ST NW APT B
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City | WASHINGTON
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State | DC
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Zip | 20001-2277
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Country | US
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Telephone | 703-618-8865
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Fax |
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Provider Business Mailing Address
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Address Line | 1423 1ST ST NW APT B
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City | WASHINGTON
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State | DC
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Zip | 20001-2277
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Country | US
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Telephone | 703-618-8865
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MRS. STACEY ELAINE PECAR
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Credential | OTR/L
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Telephone | 703-618-8865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT010000830
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License Number State | DC
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