Provider Demographics
NPI:1457092504
Name:OTAH-MCDOWELL, TRICIA ONYEYANCHUKWUKA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:ONYEYANCHUKWUKA
Last Name:OTAH-MCDOWELL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:TRICIA
Other - Middle Name:ONYEYANCHUKWUKA
Other - Last Name:OTAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14101 LUNNET CT
Mailing Address - Street 2:
Mailing Address - City:ACCOKEEK
Mailing Address - State:MD
Mailing Address - Zip Code:20607-4717
Mailing Address - Country:US
Mailing Address - Phone:412-417-0771
Mailing Address - Fax:
Practice Address - Street 1:1400 NALLEY TER
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-4434
Practice Address - Country:US
Practice Address - Phone:240-696-3218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09553225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist