MEDICARE: MRS. ELIZABETH A SENAYA-DAGADU

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
1	224Z00000X	Occupational Therapy Assistant	A00438	MD

General Provider Information

NPI Number	:	1346596723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH A SENAYA-DAGADU

Provider Business Mailing Address
First Line	:	3112 BUNKER DR
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-2289
Country	:	US
Telephone Number	:	443-745-7971
Fax Number	:

Provider Business Practice Location Address
First Line	:	3112 BUNKER DR
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-2289
Country	:	US
Telephone Number	:	443-745-7971
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2012
Last Update Date	:	08/03/2012

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