Larissa Teal Pauly, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

06826 Issued in MD

Practice address

8638 Veterans Hwy FL 1
Millersville, MD 21108-1422

Phone

(443) 481-1140

Fax

(410) 729-4526

NPI assigned

Jul 24, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Larissa Sharshon Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1114404902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 DEFENSE HWY STE 100",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214018902",
            "telephone_number": "667-204-7000",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8638 VETERANS HWY FL 1",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211081422",
            "telephone_number": "443-481-1140",
            "fax_number": "410-729-4526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULY",
        "first_name": "LARISSA",
        "middle_name": "TEAL",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "06826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARISSA",
            "last_name": "SHARSHON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapist in Millersville, MD
• Providers in Millersville, MD by specialty
• Occupational Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.