Healthcare Provider Details

I. General information

NPI: 1851602676
Provider Name (Legal Business Name): DOLORES GEBHARDT MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2010
Last Update Date: 06/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 KELLER RD
PIKESVILLE MD
21208-1308
US

IV. Provider business mailing address

11 KELLER RD
PIKESVILLE MD
21208-1308
US

V. Phone/Fax

Practice location:
  • Phone: 410-415-5260
  • Fax: 410-415-5261
Mailing address:
  • Phone: 410-415-5260
  • Fax: 410-415-5261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number04995
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: