Provider Demographics
NPI:1679217210
Name:GELINE, JILL S (OT)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:S
Last Name:GELINE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 CONNECTICUT AVE STE 910
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-5803
Mailing Address - Country:US
Mailing Address - Phone:301-946-4100
Mailing Address - Fax:301-962-7480
Practice Address - Street 1:8401 CONNECTICUT AVE STE 910
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-5803
Practice Address - Country:US
Practice Address - Phone:301-946-4100
Practice Address - Fax:301-962-7480
Is Sole Proprietor?:No
Enumeration Date:2022-04-20
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDT01254225X00000X
225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist