Provider Demographics
NPI:1992105100
Name:FARRELL, KASEY (OTR/L)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:
Last Name:FARRELL
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 1:4833 RUGBY AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3035
Mailing Address - Country:US
Mailing Address - Phone:301-523-0902
Mailing Address - Fax:301-668-7008
Practice Address - Street 1:4833 RUGBY AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3035
Practice Address - Country:US
Practice Address - Phone:301-523-0902
Practice Address - Fax:301-668-7008
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04438225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics