Healthcare Provider Details

I. General information

NPI: 1407181902
Provider Name (Legal Business Name): INGRID ZWAARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2009
Last Update Date: 10/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 MILKSHAKE LN
ANNAPOLIS MD
21403-1507
US

IV. Provider business mailing address

900 BAY RIDGE AVE
ANNAPOLIS MD
21403-3030
US

V. Phone/Fax

Practice location:
  • Phone: 410-269-5100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number04149
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: