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NPI Code Detail

MEDICARE: CHESAPEAKE OCCUPATIONAL THERAPY ASSOCIATES, LLC

MEDICARE: CHESAPEAKE OCCUPATIONAL THERAPY ASSOCIATES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0400XRehabilitation Clinic/Center02570MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1115 447 8501OTHERMDNPI

General Provider Information

NPI Number : 1134365778
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHESAPEAKE OCCUPATIONAL THERAPY ASSOCIATES, LLC
Provider Business Mailing Address
First Line : 1419 FOREST DR
Second Line : SUITE 210
City : ANNAPOLIS
State : MD
Zip : 21403-1482
Country : US
Telephone Number : 410-280-8774
Fax Number :
Provider Business Practice Location Address
First Line : 1419 FOREST DR
Second Line : SUITE 210
City : ANNAPOLIS
State : MD
Zip : 21403-1482
Country : US
Telephone Number : 410-280-8774
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MS. DEBRA TAYLOR
Credential : OTR/L
Telephone Number : 410-280-8774
Provider Enumeration Date : 01/04/2009
Last Update Date : 01/04/2009

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