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NPI Code Detail

MEDICARE: ELISABETH GRANT MCLEAN MS, OTR-L

MEDICARE: ELISABETH GRANT MCLEAN MS, OTR-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
1225X00000XOccupational Therapist0119008317VA

General Provider Information

NPI Number : 1972627206
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISABETH GRANT MCLEAN MS, OTR-L
Provider Business Mailing Address
First Line : 2527 OAKHAMPTON PL
Second Line :
City : HERNDON
State : VA
Zip : 20171-2704
Country : US
Telephone Number : 619-796-3765
Fax Number :
Provider Business Practice Location Address
First Line : 14901 BOGLE DR STE 100
Second Line :
City : CHANTILLY
State : VA
Zip : 20151-1736
Country : US
Telephone Number : 571-346-3781
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 04/24/2025

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