Provider Demographics
NPI:1588815500
Name:GREENWOOD, ALLISON STACY GURWITZ (OTR/L, ATP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:STACY GURWITZ
Last Name:GREENWOOD
Suffix:
Gender:F
Credentials:OTR/L, ATP
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:STACY
Other - Last Name:GURWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2200 KERNAN DR RM 1427
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-6665
Mailing Address - Country:US
Mailing Address - Phone:410-448-6896
Mailing Address - Fax:410-448-6791
Practice Address - Street 1:2200 KERNAN DR RM 1427
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-6665
Practice Address - Country:US
Practice Address - Phone:410-448-6896
Practice Address - Fax:410-448-6791
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XP0019X
MD05623225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD093575100Medicaid
MD093575100Medicaid