Provider Demographics
NPI:1558512905
Name:FARAG, FELICIA A (MS OT)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:A
Last Name:FARAG
Suffix:
Gender:F
Credentials:MS OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11908 BRISTOL MANOR CT
Mailing Address - Street 2:
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-5804
Mailing Address - Country:US
Mailing Address - Phone:301-881-1394
Mailing Address - Fax:
Practice Address - Street 1:11908 BRISTOL MANOR CT
Practice Address - Street 2:LITTLE SPROUT SPEECH
Practice Address - City:NORTH BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20852-5804
Practice Address - Country:US
Practice Address - Phone:301-881-1394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-03
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06215225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist