Individual
SUE M PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
626 TRAIL AVE, FREDERICK, MD 21701-4934
(301) 662-1997
(301) 668-2202
Mailing address
626 TRAIL AVE, FREDERICK, MD 21701-4934
(301) 662-1997
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
03023
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KBC4HO-61389301
BC/BS
MD
01
—
S404-0007
CAREFIRST
MD
Enumeration date
07/25/2006
Last updated
07/11/2008
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