Provider Demographics
NPI:1952457889
Name:KING, JEANINE MARIE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JEANINE
Middle Name:MARIE
Last Name:KING
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:JEANINE
Other - Middle Name:MARIE
Other - Last Name:THOMAS/LINDENSTRUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:400 CORNICHE CT
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21158-4449
Mailing Address - Country:US
Mailing Address - Phone:410-751-6800
Mailing Address - Fax:
Practice Address - Street 1:400 CORNICHE CT
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21158-4449
Practice Address - Country:US
Practice Address - Phone:410-751-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02915225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD572250OtherOPTIMUM CHOICE
MD71553557OtherAETNA
R3210001OtherFEDERAL BLUECROSS
MD300155441OtherKAISER PERMANENTE
MDKCY8OtherCAREFIRST BLUECROSS
MD30015544OtherCIGNA
MD300155441OtherMAMSI