Provider Demographics
NPI:1336702893
Name:SZCZEPKOWSKI, JACQUELYN K (OTR/L)
Entity Type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:K
Last Name:SZCZEPKOWSKI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 LLEWELLYN FIELD RD
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1134
Mailing Address - Country:US
Mailing Address - Phone:240-449-5339
Mailing Address - Fax:
Practice Address - Street 1:11140 ROCKVILLE PIKE STE 303
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3148
Practice Address - Country:US
Practice Address - Phone:301-231-7138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08728225X00000X
MD418839225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist