Healthcare Provider Details

I. General information

NPI: 1760070486
Provider Name (Legal Business Name): KRISTEN ELIZABETH TRALONGO OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2021
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 YORK RD
TOWSON MD
21204-7513
US

IV. Provider business mailing address

7789 OUTING AVE
PASADENA MD
21122-1544
US

V. Phone/Fax

Practice location:
  • Phone: 410-821-5500
  • Fax:
Mailing address:
  • Phone: 443-452-9091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number10705
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: