Provider Demographics
NPI:1831871052
Name:PRICE-CLEARE, MYASIA (MOT, OT/LT)
Entity type:Individual
Prefix:MS
First Name:MYASIA
Middle Name:
Last Name:PRICE-CLEARE
Suffix:
Gender:F
Credentials:MOT, OT/LT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4117 WARNER AVE APT C8
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1955
Mailing Address - Country:US
Mailing Address - Phone:804-714-7865
Mailing Address - Fax:
Practice Address - Street 1:4200 PARLIAMENT PL # 550
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-1849
Practice Address - Country:US
Practice Address - Phone:240-245-4370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDT01252225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics