Provider Demographics
NPI:1679612345
Name:GROT, DASHA (OT)
Entity Type:Individual
Prefix:MISS
First Name:DASHA
Middle Name:
Last Name:GROT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N ST NW
Mailing Address - Street 2:APT 309
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-3678
Mailing Address - Country:US
Mailing Address - Phone:202-257-8425
Mailing Address - Fax:
Practice Address - Street 1:7401 OSLER DR
Practice Address - Street 2:SUITE 110
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7673
Practice Address - Country:US
Practice Address - Phone:410-296-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01190035225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD650025-01OtherBC BS