Healthcare Provider Details

I. General information

NPI: 1851962138
Provider Name (Legal Business Name): MISHAYLA JANAE CHATARD OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISHAYLA JANAE SMITH OTD, OTR/L

II. Dates (important events)

Enumeration Date: 07/07/2021
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N BROADWAY
BALTIMORE MD
21205-1424
US

IV. Provider business mailing address

6407 BLENHEIM RD
BALTIMORE MD
21212-1716
US

V. Phone/Fax

Practice location:
  • Phone: 443-923-9200
  • Fax:
Mailing address:
  • Phone: 832-444-5755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number09338
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: