Healthcare Provider Details

I. General information

NPI: 1912507922
Provider Name (Legal Business Name): THERAPY IN MOTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2020
Last Update Date: 10/28/2020
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10521 PATUXENT RIDGE WAY
LAUREL MD
20723-5719
US

IV. Provider business mailing address

10521 PATUXENT RIDGE WAY
LAUREL MD
20723-5719
US

V. Phone/Fax

Practice location:
  • Phone: 410-353-7589
  • Fax:
Mailing address:
  • Phone: 410-353-7589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. KATHRYN ANNE HERNANDEZ
Title or Position: OWNER
Credential: DPT
Phone: 410-353-7589