Healthcare Provider Details

I. General information

NPI: 1285620864
Provider Name (Legal Business Name): KATHLEEN KEYS VALENTINO PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHLEEN KEYS MCFADDEN-VALENTINO

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 04/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

598 CYNWOOD DR STE 101
EASTON MD
21601-3875
US

IV. Provider business mailing address

659 S SALISBURY BLVD STE 1B
SALISBURY MD
21801-5458
US

V. Phone/Fax

Practice location:
  • Phone: 410-770-9720
  • Fax: 410-770-9725
Mailing address:
  • Phone: 410-831-3226
  • Fax: 410-677-0883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number16474
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: