Healthcare Provider Details

I. General information

NPI: 1871338186
Provider Name (Legal Business Name): VIRGINIA ANNE MORATZ OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2024
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11811 MEYLSTON DR
LUTHERVILLE MD
21093-1614
US

IV. Provider business mailing address

11811 MEYLSTON DR
LUTHERVILLE MD
21093-1614
US

V. Phone/Fax

Practice location:
  • Phone: 410-458-8636
  • Fax:
Mailing address:
  • Phone: 410-458-8636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number01278
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number01278
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number01278
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: