Provider Demographics
NPI:1598281701
Name:MORELAND, EMILY KATHERINE (OTA)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:KATHERINE
Last Name:MORELAND
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:KATHERINE
Other - Last Name:MCHALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1221 WAUGH CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054-1608
Mailing Address - Country:US
Mailing Address - Phone:410-923-2020
Mailing Address - Fax:
Practice Address - Street 1:1221 WAUGH CHAPEL RD
Practice Address - Street 2:
Practice Address - City:GAMBRILLS
Practice Address - State:MD
Practice Address - Zip Code:21054-1608
Practice Address - Country:US
Practice Address - Phone:410-923-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-18
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDT00393224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant