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NPI Code Detail

MEDICARE: MRS. REBECCA WLODARCZYK

MEDICARE: MRS. REBECCA WLODARCZYK
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
1224Z00000XOccupational Therapy AssistantA02369MD

General Provider Information

NPI Number : 1306391263
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REBECCA WLODARCZYK
Provider Business Mailing Address
First Line : 3402 KEATS TER
Second Line :
City : IJAMSVILLE
State : MD
Zip : 21754-9029
Country : US
Telephone Number : 301-363-8642
Fax Number :
Provider Business Practice Location Address
First Line : 347 BALLENGER CENTER DR
Second Line :
City : FREDERICK
State : MD
Zip : 21703-7095
Country : US
Telephone Number : 301-663-5181
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2016
Last Update Date : 08/22/2016

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