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NPI Code Detail

MEDICARE: ALLYSA LEE WINEGAR

MEDICARE: ALLYSA LEE WINEGAR
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
1224Z00000XOccupational Therapy AssistantA03118MD

General Provider Information

NPI Number : 1801664719
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLYSA LEE WINEGAR
Provider Business Mailing Address
First Line : 2540 LOG MILL CT
Second Line :
City : CROFTON
State : MD
Zip : 21114-1863
Country : US
Telephone Number : 301-395-5560
Fax Number :
Provider Business Practice Location Address
First Line : 11150 RESORT RD
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21042-2050
Country : US
Telephone Number : 410-461-7070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2023
Last Update Date : 12/20/2023

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Directions to “ ALLYSA LEE WINEGAR ” Practice Location

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