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Individual

STACEY A HARCUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
2200 KERNAN DR, GWYNN OAK, MD 21207-6665
(410) 448-2500
Mailing address
1576 DELLSWAY RD, TOWSON, MD 21286-5901
(571) 276-4411

Taxonomy

Speciality
Code
Description
License number
State
225XN1300X
Neurorehabilitation Occupational Therapist
Primary
06748
MD
225XP0019X
Physical Rehabilitation Occupational Therapist
06748
MD

Other

Enumeration date
01/24/2017
Last updated
01/24/2017
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