Provider Demographics
NPI:1235619594
Name:TAYLOR, RUTH FELICITY (OTR)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:FELICITY
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2704 EGRET WAY
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-1912
Mailing Address - Country:US
Mailing Address - Phone:301-502-0231
Mailing Address - Fax:301-371-3913
Practice Address - Street 1:6012 JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-6953
Practice Address - Country:US
Practice Address - Phone:301-371-7160
Practice Address - Fax:301-371-3913
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05209225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist