Provider Demographics
NPI:1225584782
Name:HOUDEK, ALLISON (COTA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:HOUDEK
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8626 BROOKS DR
Mailing Address - Street 2:UNIT 303
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-7419
Mailing Address - Country:US
Mailing Address - Phone:410-822-2213
Mailing Address - Fax:410-822-2963
Practice Address - Street 1:8626 BROOKS DR
Practice Address - Street 2:UNIT 303
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-7419
Practice Address - Country:US
Practice Address - Phone:410-822-2213
Practice Address - Fax:410-822-2963
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA02353224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant