MEDICARE: MS. SHAKEYA HABIB 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	010000974	DC
2	225X00000X	Occupational Therapist	235793	MD

General Provider Information

NPI Number	:	1750787081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHAKEYA HABIB MS, OTR/L

Provider Business Mailing Address
First Line	:	7511 WILHELM DR
Second Line	:
City	:	LANHAM
State	:	MD
Zip	:	20706-3738
Country	:	US
Telephone Number	:	301-254-7256
Fax Number	:

Provider Business Practice Location Address
First Line	:	680 RHODE ISLAND AVE NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-1269
Country	:	US
Telephone Number	:	202-575-5404
Fax Number	:

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

Provider Enumeration Date	:	11/13/2014
Last Update Date	:	11/13/2014

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