Healthcare Provider Details

I. General information

NPI: 1760071856
Provider Name (Legal Business Name): THE THERAPY INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2021
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2715 MATAPEAKE DR
UPPER MARLBORO MD
20774-9479
US

IV. Provider business mailing address

2715 MATAPEAKE DR
UPPER MARLBORO MD
20774-9479
US

V. Phone/Fax

Practice location:
  • Phone: 240-418-0385
  • Fax: 888-991-2368
Mailing address:
  • Phone: 240-418-0385
  • Fax: 888-991-2368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. FREDERICK COVINGTON
Title or Position: FOUNDER
Credential:
Phone: 240-418-0385