Provider Demographics
NPI:1851908693
Name:NEUBERGER, KENDALL LYNN (OTR)
Entity Type:Individual
Prefix:
First Name:KENDALL
Middle Name:LYNN
Last Name:NEUBERGER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 SCOTTS LEVEL RD
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-2104
Mailing Address - Country:US
Mailing Address - Phone:410-887-0763
Mailing Address - Fax:
Practice Address - Street 1:8301 SCOTTS LEVEL RD
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-2104
Practice Address - Country:US
Practice Address - Phone:410-887-0763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
MD09302225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist