Healthcare Provider Details

I. General information

NPI: 1477757755
Provider Name (Legal Business Name): OUT CAME THE SUN FOUNDATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 12/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SAINT PAUL ST SUITE 1660
BALTIMORE MD
21202-1626
US

IV. Provider business mailing address

PO BOX 1687
ROCKVILLE MD
20849-1687
US

V. Phone/Fax

Practice location:
  • Phone: 301-649-7170
  • Fax: 301-260-8487
Mailing address:
  • Phone: 301-649-7170
  • Fax: 301-260-8487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: LORI ANN AYANIAN MADHOK
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 301-649-7170