Healthcare Provider Details

I. General information

NPI: 1104544121
Provider Name (Legal Business Name): LARISSA ANN THRIFT MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2022
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 LANGDON DR
WESTMINSTER MD
21158-2503
US

IV. Provider business mailing address

125 N COURT ST
WESTMINSTER MD
21157-5192
US

V. Phone/Fax

Practice location:
  • Phone: 410-751-3203
  • Fax:
Mailing address:
  • Phone: 410-751-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number09642
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: