Provider Demographics
NPI:1093141921
Name:SCHMITZ, ALICIA MARIE (COTA/L)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:MARIE
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:MARIE
Other - Last Name:CAVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:11861 HOLLY PLAINS DR
Mailing Address - Street 2:
Mailing Address - City:RIDGELY
Mailing Address - State:MD
Mailing Address - Zip Code:21660-1846
Mailing Address - Country:US
Mailing Address - Phone:717-576-5612
Mailing Address - Fax:
Practice Address - Street 1:7330 STATUM RD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MD
Practice Address - Zip Code:21629-2637
Practice Address - Country:US
Practice Address - Phone:717-576-5612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-24
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA02033224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant