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General NPI Number Information
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NPI Number | 1134365778
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Entity Type | Organization
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Legal Business Name | CHESAPEAKE OCCUPATIONAL THERAPY ASSOCIATES, LLC
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Dates
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Enumeration Date | 01/04/2009
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Last Update Date | 01/04/2009
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Provider Practice Location Address
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Address Line | 1419 FOREST DR SUITE 210
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City | ANNAPOLIS
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State | MD
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Zip | 21403-1482
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Country | US
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Telephone | 410-280-8774
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Fax |
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Provider Business Mailing Address
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Address Line | 1419 FOREST DR SUITE 210
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City | ANNAPOLIS
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State | MD
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Zip | 21403-1482
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Country | US
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Telephone | 410-280-8774
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. DEBRA TAYLOR
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Credential | OTR/L
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Telephone | 410-280-8774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 02570
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License Number State | MD
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