Healthcare Provider Details

I. General information

NPI: 1518887264
Provider Name (Legal Business Name): GRACE MARTINO OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12520 PROSPERITY DR STE 220
SILVER SPRING MD
20904-1660
US

IV. Provider business mailing address

12520 PROSPERITY DR STE 220
SILVER SPRING MD
20904-1660
US

V. Phone/Fax

Practice location:
  • Phone: 301-869-7505
  • Fax:
Mailing address:
  • Phone: 301-869-7505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number10801
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: