Provider Demographics
NPI:1821242520
Name:HUSBAND, KAFAYAT (OT)
Entity Type:Individual
Prefix:
First Name:KAFAYAT
Middle Name:
Last Name:HUSBAND
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:HUSBAND
Other - Middle Name:
Other - Last Name:THERAPEUTICS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 76685
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20013-6685
Mailing Address - Country:US
Mailing Address - Phone:202-905-1155
Mailing Address - Fax:
Practice Address - Street 1:404 KENTUCKY AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3009
Practice Address - Country:US
Practice Address - Phone:202-905-1155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT665225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC1821242520Medicaid