MEDICARE: KRISTEN G MASCI MS, 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
2	225XP0200X	Pediatric Occupational Therapist	OT956	DC
3	225XP0200X	Pediatric Occupational Therapist	0119003125	VA
4	225XP0200X	Pediatric Occupational Therapist	956	DC

General Provider Information

NPI Number	:	1457649758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN G MASCI MS, OTR/L

Provider Business Mailing Address
First Line	:	4748 24TH RD N
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22207-3552
Country	:	US
Telephone Number	:	301-509-1461
Fax Number	:	202-379-1797

Provider Business Practice Location Address
First Line	:	1301 PENNSYLVANIA AVE SE BSMT
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20003-3027
Country	:	US
Telephone Number	:	202-544-5439
Fax Number	:	202-379-1797

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

Provider Enumeration Date	:	07/20/2011
Last Update Date	:	08/03/2022

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