MEDICARE: JOANNA FRANK 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	225X00000X	Occupational Therapist	09259	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	09259	OTHER	MD	STATE LICENSE

General Provider Information

NPI Number	:	1962816215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNA FRANK OT

Provider Business Mailing Address
First Line	:	203 YORKSHIRE WAY APT C
Second Line	:
City	:	BEL AIR
State	:	MD
Zip	:	21014-6614
Country	:	US
Telephone Number	:	410-693-0949
Fax Number	:

Provider Business Practice Location Address
First Line	:	807A S UNION AVE
Second Line	:
City	:	HAVRE DE GRACE
State	:	MD
Zip	:	21078-3610
Country	:	US
Telephone Number	:	410-939-2262
Fax Number	:	410-939-7119

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

Provider Enumeration Date	:	06/15/2014
Last Update Date	:	03/29/2021

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