Provider Demographics
NPI:1851873533
Name:RAY, TANYA SANDHU (OTR/L)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:SANDHU
Last Name:RAY
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 1:9826 DARCY FOREST DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1166
Mailing Address - Country:US
Mailing Address - Phone:202-999-0744
Mailing Address - Fax:
Practice Address - Street 1:6121 MONTROSE RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4803
Practice Address - Country:US
Practice Address - Phone:301-816-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08140225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD08140OtherMARYLAND STATE LICENSE