Provider Demographics
NPI:1093966780
Name:THORPE, JUDY S (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:S
Last Name:THORPE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JUDICE
Other - Middle Name:S
Other - Last Name:OBIRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6310 STEVENS FOREST RD STE 140
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-3490
Mailing Address - Country:US
Mailing Address - Phone:443-542-0900
Mailing Address - Fax:443-542-0474
Practice Address - Street 1:6310 STEVENS FOREST RD STE 140
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1036
Practice Address - Country:US
Practice Address - Phone:443-542-0900
Practice Address - Fax:443-542-0474
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20968174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD416634500Medicaid
MD147447Medicare PIN