Individual
MARY PAT FASICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
122 DEFENSE HWY, 224, ANNAPOLIS, MD 21401-7069
(410) 864-8718
(443) 716-0415
Mailing address
14 GIDDINGS AVE, SEVERNA PARK, MD 21146-3308
(410) 647-5596
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
05646
MD
Other
Enumeration date
05/12/2007
Last updated
07/08/2007
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