Provider Demographics
NPI:1952577330
Name:ABERCROMBIE, DEVARA L (OTR/L)
Entity Type:Individual
Prefix:
First Name:DEVARA
Middle Name:L
Last Name:ABERCROMBIE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4354 VARNUM PL NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2101
Mailing Address - Country:US
Mailing Address - Phone:202-635-6414
Mailing Address - Fax:202-882-2889
Practice Address - Street 1:4354 VARNUM PL NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2101
Practice Address - Country:US
Practice Address - Phone:202-635-6414
Practice Address - Fax:202-882-2889
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT553225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist