Provider Demographics
NPI:1437366440
Name:DECARLO, CHRISTINE (MS OTRL)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:DECARLO
Suffix:
Gender:F
Credentials:MS OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 HARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5814
Mailing Address - Country:US
Mailing Address - Phone:443-591-0343
Mailing Address - Fax:
Practice Address - Street 1:407 HARWOOD RD
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-5814
Practice Address - Country:US
Practice Address - Phone:443-591-0343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05311225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics