MEDICARE: MS. ELYCE BRAUWERMAN OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	05536	MD
2	225X00000X	Occupational Therapist	OT00004268	WA

General Provider Information

NPI Number	:	1134242480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELYCE BRAUWERMAN OTR/L

Provider Business Mailing Address
First Line	:	1410 AINTREE DR
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20850-2955
Country	:	US
Telephone Number	:	240-441-5918
Fax Number	:

Provider Business Practice Location Address
First Line	:	8001 LYNBROOK DR
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-4642
Country	:	US
Telephone Number	:	301-657-4959
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	05/26/2023

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