Provider Demographics
NPI:1871025478
Name:ANDERSON, TODD (OTR/L, CHT, CLT)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:OTR/L, CHT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 N CLEVELAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5000
Mailing Address - Country:US
Mailing Address - Phone:301-733-3844
Mailing Address - Fax:301-733-3804
Practice Address - Street 1:227 N CLEVELAND AVENUE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5000
Practice Address - Country:US
Practice Address - Phone:301-733-3844
Practice Address - Fax:301-733-3804
Is Sole Proprietor?:No
Enumeration Date:2017-04-01
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03248225X00000X
WV833225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist