Healthcare Provider Details

I. General information

NPI: 1316871809
Provider Name (Legal Business Name): REVIVING ABILITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12127 TRIPLE CROWN RD
NORTH POTOMAC MD
20878-3788
US

IV. Provider business mailing address

12127 TRIPLE CROWN RD
NORTH POTOMAC MD
20878-3788
US

V. Phone/Fax

Practice location:
  • Phone: 301-789-7399
  • Fax:
Mailing address:
  • Phone: 301-789-7399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: EMILY PAIGE MEREDITH
Title or Position: OWNER
Credential: OTD RL
Phone: 301-789-7399