Provider Demographics
NPI:1760733919
Name:O'BRIEN, DEIRDRE C (PT)
Entity Type:Individual
Prefix:MS
First Name:DEIRDRE
Middle Name:C
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1852 REISTERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-1392
Mailing Address - Country:US
Mailing Address - Phone:410-484-8488
Mailing Address - Fax:
Practice Address - Street 1:1852 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-1392
Practice Address - Country:US
Practice Address - Phone:410-484-8488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist