MEDICARE: ROXANNE DEPIETRO-HARTMAN 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	04319	MD

General Provider Information

NPI Number	:	1326631516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROXANNE DEPIETRO-HARTMAN OTR/L

Provider Business Mailing Address
First Line	:	8301 JUMPING FIELD CT
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-6995
Country	:	US
Telephone Number	:	410-530-8832
Fax Number	:

Provider Business Practice Location Address
First Line	:	3004 N RIDGE RD
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-3381
Country	:	US
Telephone Number	:	410-461-9494
Fax Number	:

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

Provider Enumeration Date	:	02/18/2021
Last Update Date	:	02/18/2021

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Directions to “ ROXANNE DEPIETRO-HARTMAN OTR/L” Practice Location

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