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NPI Code Detail

MEDICARE: CHARM CITY THERAPY

MEDICARE: CHARM CITY THERAPY
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
1390200000XStudent in an Organized Health Care Education/Training Program05807MD
2261QM1300XMulti-Specialty Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609204999
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHARM CITY THERAPY
Provider Business Mailing Address
First Line : 2405 STEELE RD
Second Line :
City : BALTIMORE
State : MD
Zip : 21209-3924
Country : US
Telephone Number : 410-849-9496
Fax Number :
Provider Business Practice Location Address
First Line : 7 GWYNNS MILL CT STE I
Second Line :
City : OWINGS MILLS
State : MD
Zip : 21117-3528
Country : US
Telephone Number : 410-849-9496
Fax Number :
Authorized Official
Title or Position : OCCUPATION THERAPIST
Name : ELANA WISE
Credential : OT
Telephone Number : 404-502-6942
Provider Enumeration Date : 10/23/2013
Last Update Date : 08/09/2024

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Directions to “CHARM CITY THERAPY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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