Healthcare Provider Details

I. General information

NPI: 1710744271
Provider Name (Legal Business Name): DISTRICT THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2024
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 BALDWIN AVE STE 204
CROFTON MD
21114-2419
US

IV. Provider business mailing address

7850 OYSTER SHELL CT
STONEY BEACH MD
21226-2153
US

V. Phone/Fax

Practice location:
  • Phone: 443-292-2353
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: RUBY CAI
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 240-593-5439