Provider Demographics
NPI:1821181397
Name:SIMPSON, TERESA (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17904 GEORGIA AVENUE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832
Mailing Address - Country:US
Mailing Address - Phone:301-232-1050
Mailing Address - Fax:310-232-1044
Practice Address - Street 1:17904 GEORGIA AVENUE
Practice Address - Street 2:SUITE 215
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832
Practice Address - Country:US
Practice Address - Phone:301-232-1050
Practice Address - Fax:301-232-1044
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2013-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20853225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD229072ZBDVMedicare PIN