MEDICARE: TANYA BROWN OT/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	OT617	DC

General Provider Information

NPI Number	:	1902214299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANYA BROWN OT/L

Provider Business Mailing Address
First Line	:	13000 PISCATAWAY DR
Second Line	:
City	:	FT WASHINGTON
State	:	MD
Zip	:	20744-6620
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3323 7TH ST SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20032-4212
Country	:	US
Telephone Number	:	301-801-1534
Fax Number	:

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

Provider Enumeration Date	:	07/30/2014
Last Update Date	:	07/30/2014

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Directions to “ TANYA BROWN OT/L” Practice Location

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