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General NPI Number Information
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NPI Number | 1598233009
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Entity Type | Individual
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Provider Name | ELISABETH MONTALVO
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Gender | Female
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Dates
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Enumeration Date | 11/02/2018
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Last Update Date | 11/02/2018
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Provider Practice Location Address
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Address Line | 18100 SLADE SCHOOL RD
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City | SANDY SPRING
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State | MD
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Zip | 20860-1313
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Country | US
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Telephone | 301-924-2811
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Fax |
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Provider Business Mailing Address
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Address Line | 10401 GROSVENOR PL APT 304
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City | ROCKVILLE
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State | MD
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Zip | 20852-4630
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Country | US
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Telephone | 517-652-5833
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 08442
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License Number State | MD
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