Provider Demographics
NPI:1861158693
Name:EHRMANN, ALISA (DPT)
Entity type:Individual
Prefix:
First Name:ALISA
Middle Name:
Last Name:EHRMANN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4105 YARDLEY CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-1401
Mailing Address - Country:US
Mailing Address - Phone:301-655-5864
Mailing Address - Fax:
Practice Address - Street 1:8926 WOODYARD RD STE 501
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4234
Practice Address - Country:US
Practice Address - Phone:301-719-1140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-16
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28762225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD11363488590Medicaid