Individual
GAIL BACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5980 RADIO STATION RD, LA PLATA, MD 20646-3337
(301) 751-2151
Mailing address
7300 DENISE LN, HUGHESVILLE, MD 20637-2335
(301) 751-2151
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
12/20/2018
Last updated
12/20/2018
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