Provider Demographics
NPI:1609229483
Name:BRAWERMAN, MARISA ANN (PT , DPT)
Entity Type:Individual
Prefix:DR
First Name:MARISA
Middle Name:ANN
Last Name:BRAWERMAN
Suffix:
Gender:F
Credentials:PT , DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:966 COACHWAY
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-6411
Mailing Address - Country:US
Mailing Address - Phone:443-271-2530
Mailing Address - Fax:
Practice Address - Street 1:11333 WOODGLEN DR STE 204
Practice Address - Street 2:
Practice Address - City:NORTH BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20852-3081
Practice Address - Country:US
Practice Address - Phone:443-271-2530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25938225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist