Provider Demographics
NPI:1497367239
Name:TABOADA, CHESSA NEKKA ADLAWAN (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:CHESSA NEKKA
Middle Name:ADLAWAN
Last Name:TABOADA
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 1:1242 FRANCES PL
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1790
Mailing Address - Country:US
Mailing Address - Phone:443-248-7208
Mailing Address - Fax:
Practice Address - Street 1:1242 FRANCES PL
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-1790
Practice Address - Country:US
Practice Address - Phone:443-248-7208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09055225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics