Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XE0001X | Environmental Modification | 04490 | MD |
N | 225XF0002X | Feeding, Eating & Swallowing | 04490 | MD |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 04490 | MD |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 04490 | MD |
NPI | 1346631777 |
---|---|
Provider Name | Jamie Sandbank |
First Address | Ellicott City, MD 21042-3743 |
Second Address | Ellicott City, MD 21042-3743 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2015 |
Last Update Date | 06/02/2015 |