=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942766910
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEBORAH LYNN ADORNATO
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/14/2019
-----------------------------------------------------
Last Update Date | 02/14/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 410 E MACPHAIL RD
-----------------------------------------------------
City | BEL AIR
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21014-4410
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-420-6144
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2200 TORY WAY
-----------------------------------------------------
City | FOREST HILL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21050-2653
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-803-4157
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 02413
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------