MEDICARE: KERRY L VIARDO OT

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	225XF0002X	Feeding, Eating & Swallowing Occupational Therapist	03943	MD
2	225XP0200X	Pediatric Occupational Therapist	03943	MD

General Provider Information

NPI Number	:	1942738778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERRY L VIARDO OT

Provider Business Mailing Address
First Line	:	483 CREEKS END LN
Second Line	:
City	:	STEVENSVILLE
State	:	MD
Zip	:	21666-2572
Country	:	US
Telephone Number	:	410-490-8560
Fax Number	:

Provider Business Practice Location Address
First Line	:	207 RIDGELY AVE
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-1303
Country	:	US
Telephone Number	:	410-490-8560
Fax Number	:

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

Provider Enumeration Date	:	05/24/2017
Last Update Date	:	05/24/2017

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Directions to “ KERRY L VIARDO OT” Practice Location

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