Provider Demographics
NPI:1568934461
Name:COPELAND, DOROTHEA THOMPSON (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:DOROTHEA
Middle Name:THOMPSON
Last Name:COPELAND
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 PERDER LN
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:MD
Mailing Address - Zip Code:21037-2728
Mailing Address - Country:US
Mailing Address - Phone:240-460-1493
Mailing Address - Fax:
Practice Address - Street 1:21 PERDER LN
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-2728
Practice Address - Country:US
Practice Address - Phone:240-460-1493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02767225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist