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General NPI Number Information
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NPI Number | 1669126041
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Entity Type | Organization
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Legal Business Name | THERAPELVIC OCCUPATIONAL THERAPY
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Dates
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Enumeration Date | 02/04/2022
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 2712 CARRINGTON CT
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City | SUNDERLAND
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State | MD
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Zip | 20689-3030
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Country | US
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Telephone | 701-578-5275
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Fax |
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Provider Business Mailing Address
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Address Line | 2712 CARRINGTON CT
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City | SUNDERLAND
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State | MD
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Zip | 20689-3030
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Country | US
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Telephone | 701-578-5275
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Fax |
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Authorized Official
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Title or Position | OWNER/OCCUPATIONAL THERAPIST
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Name | MRS. DANIELLE SHEA
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Credential | MSOTR/L
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Telephone | 701-578-5275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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