Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 06683 | MD |
NPI | 1114284031 |
---|---|
Provider Name | Ms. Sherylin Denise Davis |
First Address | Ellicott City, MD 21043-6975 |
Second Address | Burtonsville, MD 20866-1715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2012 |
Last Update Date | 17/04/2012 |