=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932573946
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SAMEERA QURESHI M.S. OT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/16/2015
-----------------------------------------------------
Last Update Date | 11/16/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1200 1ST ST NE C/O HUMAN RESOURCES
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20002-3361
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 403-605-8990
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 145 POINT DRIVE NW APT. 1105
-----------------------------------------------------
City | CALGARY
-----------------------------------------------------
State | ALBERTA
-----------------------------------------------------
Zip | T3B 4W1
-----------------------------------------------------
Country | CA
-----------------------------------------------------
Telephone | 14036058990
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225XP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------