Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 04994 | MD |
NPI | 1306470232 |
---|---|
Provider Name | Maureen Gorman |
First Address | Potomac, MD 20854-4418 |
Second Address | Potomac, MD 20854-4418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/02/2020 |
Last Update Date | 02/08/2021 |