Provider Demographics
NPI:1891963823
Name:FOLK, BRANDI MARIE (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:MARIE
Last Name:FOLK
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:MS
Other - First Name:BRANDI
Other - Middle Name:MARIE
Other - Last Name:FRAZEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:6500 THAYER CTR
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-1116
Mailing Address - Country:US
Mailing Address - Phone:301-334-1863
Mailing Address - Fax:301-334-5835
Practice Address - Street 1:6500 THAYER CTR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-1116
Practice Address - Country:US
Practice Address - Phone:301-334-1863
Practice Address - Fax:301-334-5835
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05091225X00000X
WV11542083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810000617Medicaid
MD186300200Medicaid
MD186300200Medicaid