Healthcare Provider Details

I. General information

NPI: 1487422986
Provider Name (Legal Business Name): MAGOTHY THERAPY & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2023
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 PENINSULA FARM RD STE I
ARNOLD MD
21012-1018
US

IV. Provider business mailing address

277 PENINSULA FARM RD STE I
ARNOLD MD
21012-1018
US

V. Phone/Fax

Practice location:
  • Phone: 410-271-3335
  • Fax:
Mailing address:
  • Phone: 410-271-3335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAITLIN BARRY
Title or Position: OWNER
Credential: MS OTR/L
Phone: 202-681-1779