Provider Demographics
NPI:1609038306
Name:UNITED CEREBRAL PALSY OF CENTRAL MD INC
Entity Type:Organization
Organization Name:UNITED CEREBRAL PALSY OF CENTRAL MD INC
Other - Org Name:UCP DELREY COMMUNITY THERAPY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:SENIOR OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:ANN MARIE
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:410-744-3151
Mailing Address - Street 1:18 DELREY AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228
Mailing Address - Country:US
Mailing Address - Phone:410-744-3151
Mailing Address - Fax:410-744-8467
Practice Address - Street 1:18 DELREY AVE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228
Practice Address - Country:US
Practice Address - Phone:410-744-3151
Practice Address - Fax:410-744-8467
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED CEREBRAL PALSY OF CENTRAL MARYLAND INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-25
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty