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General NPI Number Information
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NPI Number | 1912148842
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Entity Type | Individual
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Provider Name | TODD ALAN MISURA OTR/L
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Gender | Male
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Dates
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Enumeration Date | 03/24/2009
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Last Update Date | 03/24/2009
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Provider Practice Location Address
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Address Line | 12010 SMOKETREE RD
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City | POTOMAC
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State | MD
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Zip | 20854-3463
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Country | US
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Telephone | 301-741-1325
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Fax |
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Provider Business Mailing Address
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Address Line | 12010 SMOKETREE RD
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City | POTOMAC
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State | MD
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Zip | 20854-3463
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Country | US
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Telephone | 301-741-1325
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 05695
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT010000394
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 0119004220
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License Number State | VA
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