MEDICARE: DANIELLE ALLISON PARROTT PTA

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	225200000X	Physical Therapy Assistant	A4130	MD

General Provider Information

NPI Number	:	1780457887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE ALLISON PARROTT PTA

Provider Business Mailing Address
First Line	:	8734 CHESAPEAKE LIGHTHOUSE DR
Second Line	:
City	:	NORTH BEACH
State	:	MD
Zip	:	20714-3068
Country	:	US
Telephone Number	:	443-831-2195
Fax Number	:

Provider Business Practice Location Address
First Line	:	7611 CRAIN HWY STE C-170
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-4258
Country	:	US
Telephone Number	:	443-481-1140
Fax Number	:

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

Provider Enumeration Date	:	11/01/2023
Last Update Date	:	11/01/2023

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