Provider Demographics
NPI:1396192944
Name:BELKIN, JUDITH (MOT, OTR/L, C-SIPT)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:BELKIN
Suffix:
Gender:F
Credentials:MOT, OTR/L, C-SIPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 LASTNER LN
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-1617
Mailing Address - Country:US
Mailing Address - Phone:301-474-0290
Mailing Address - Fax:
Practice Address - Street 1:4759 RESERVOIR RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-1921
Practice Address - Country:US
Practice Address - Phone:202-965-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT867225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCOT867OtherDISTRICT OF COLUMBIA DEPARTMENT OF HEALTH OCCUPATIONAL THERAPIST LICENCE