Provider Demographics
NPI:1568583490
Name:STRONG, FELICIA THERESA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:THERESA
Last Name:STRONG
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11218 TIPPETT RD
Mailing Address - Street 2:P.O. BOX 2214
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-9645
Mailing Address - Country:US
Mailing Address - Phone:301-297-4482
Mailing Address - Fax:
Practice Address - Street 1:1 MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-9357
Practice Address - Country:US
Practice Address - Phone:301-934-4001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02891225X00000X
DCOT676225X00000X
VA0119001527225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist