Provider Demographics
NPI:1225798945
Name:BUCHALTER, SHAYNA LAUREN (OTR/L)
Entity Type:Individual
Prefix:
First Name:SHAYNA
Middle Name:LAUREN
Last Name:BUCHALTER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 14TH ST NW APT 502
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-7606
Mailing Address - Country:US
Mailing Address - Phone:443-472-6285
Mailing Address - Fax:
Practice Address - Street 1:2092 GAITHER RD STE 100
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4016
Practice Address - Country:US
Practice Address - Phone:301-424-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT010001441225X00000X
MD08942225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist