MEDICARE: FELICIA A FARAG MS OT

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	06215	MD

General Provider Information

NPI Number	:	1558512905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FELICIA A FARAG MS OT

Provider Business Mailing Address
First Line	:	11908 BRISTOL MANOR CT
Second Line	:
City	:	NORTH BETHESDA
State	:	MD
Zip	:	20852-5804
Country	:	US
Telephone Number	:	301-881-1394
Fax Number	:

Provider Business Practice Location Address
First Line	:	11908 BRISTOL MANOR CT
Second Line	:	LITTLE SPROUT SPEECH
City	:	NORTH BETHESDA
State	:	MD
Zip	:	20852-5804
Country	:	US
Telephone Number	:	301-881-1394
Fax Number	:

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

Provider Enumeration Date	:	10/03/2008
Last Update Date	:	04/13/2015

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