Healthcare Provider Details

I. General information

NPI: 1346047198
Provider Name (Legal Business Name): CYDNEY MONET DYSON OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2025
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 TOWNE PARK RD
SUITLAND MD
20746-1609
US

IV. Provider business mailing address

3101 IVY BRIDGE RD
FORT WASHINGTON MD
20744-1764
US

V. Phone/Fax

Practice location:
  • Phone: 301-817-3770
  • Fax:
Mailing address:
  • Phone: 202-538-5813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number10440
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: