Provider Demographics
NPI:1598965220
Name:SILVER, STACEY (OT)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:SILVER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:
Other - Last Name:SPECHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6410 ROCKLEDGE DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1809
Mailing Address - Country:US
Mailing Address - Phone:301-581-8051
Mailing Address - Fax:301-581-8031
Practice Address - Street 1:102 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2921
Practice Address - Country:US
Practice Address - Phone:301-581-8051
Practice Address - Fax:301-581-8031
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT010000347225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist