Provider Demographics
NPI:1831502079
Name:CASTRO, MARIA FATIMA JOANNA MALLARI (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARIA FATIMA JOANNA
Middle Name:MALLARI
Last Name:CASTRO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 UNIVERSITY BLVD W
Mailing Address - Street 2:APT. 1118
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902
Mailing Address - Country:US
Mailing Address - Phone:202-403-7816
Mailing Address - Fax:
Practice Address - Street 1:1131 UNIVERSITY BLVD W
Practice Address - Street 2:APT. 1118
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902
Practice Address - Country:US
Practice Address - Phone:202-403-7816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07167225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist