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NPI Code Detail

MEDICARE: MRS. JUNE ELAINE BROWN DAVIS OCCUPATIONAL THERAPI

MEDICARE: MRS. JUNE ELAINE BROWN DAVIS OCCUPATIONAL THERAPI
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
1225X00000XOccupational Therapist02936MD

General Provider Information

NPI Number : 1598962839
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JUNE ELAINE BROWN DAVIS OCCUPATIONAL THERAPI
Provider Business Mailing Address
First Line : 15005 JERIMIAH LN
Second Line :
City : BOWIE
State : MD
Zip : 20721-7224
Country : US
Telephone Number : 301-249-3126
Fax Number :
Provider Business Practice Location Address
First Line : 4409 E WEST HWY
Second Line :
City : RIVERDALE
State : MD
Zip : 20737-1058
Country : US
Telephone Number : 301-699-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2007
Last Update Date : 07/08/2007

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