Provider Demographics
NPI:1841709771
Name:PECAR PEDIATRIC THERAPY LLC
Entity type:Organization
Organization Name:PECAR PEDIATRIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:PECAR
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:703-618-8865
Mailing Address - Street 1:1423 1ST ST NW APT B
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-2277
Mailing Address - Country:US
Mailing Address - Phone:703-618-8865
Mailing Address - Fax:
Practice Address - Street 1:1423 1ST ST NW APT B
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-2277
Practice Address - Country:US
Practice Address - Phone:703-618-8865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT010000830225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty