Provider Demographics
NPI:1114997798
Name:VERHELLE, ELIZABETH M (OT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:VERHELLE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:128 LUBRANO DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7028
Mailing Address - Country:US
Mailing Address - Phone:410-544-4263
Mailing Address - Fax:410-994-3833
Practice Address - Street 1:128 LUBRANO DR
Practice Address - Street 2:SUITE 301
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7028
Practice Address - Country:US
Practice Address - Phone:410-544-4263
Practice Address - Fax:410-994-3833
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05154225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD269734Medicare PIN