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NPI Code Detail

MEDICARE: STACEY A HARCUM OTR/L

MEDICARE: STACEY A HARCUM 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
1225XN1300XNeurorehabilitation Occupational Therapist06748MD
2225XP0019XPhysical Rehabilitation Occupational Therapist06748MD

General Provider Information

NPI Number : 1275070609
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACEY A HARCUM OTR/L
Provider Business Mailing Address
First Line : 1576 DELLSWAY RD
Second Line :
City : TOWSON
State : MD
Zip : 21286-5901
Country : US
Telephone Number : 571-276-4411
Fax Number :
Provider Business Practice Location Address
First Line : 2200 KERNAN DR
Second Line :
City : GWYNN OAK
State : MD
Zip : 21207-6665
Country : US
Telephone Number : 410-448-2500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2017
Last Update Date : 01/24/2017

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Directions to “ STACEY A HARCUM OTR/L” Practice Location

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