Healthcare Provider Details

I. General information

NPI: 1902647514
Provider Name (Legal Business Name): MARCELINE NDAHAYO OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2024
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4833 RUGBY AVE STE 500
BETHESDA MD
20814-3910
US

IV. Provider business mailing address

3000 SILVER LAKE CT
ADELPHI MD
20783-1461
US

V. Phone/Fax

Practice location:
  • Phone: 301-523-0902
  • Fax:
Mailing address:
  • Phone: 301-633-2521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number10433
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: