Provider Demographics
NPI:1023252400
Name:WEIDLEY, LAURA SNIDER (OT)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:SNIDER
Last Name:WEIDLEY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:BETH
Other - Last Name:SNIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:8710 EMGE RD
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-3504
Mailing Address - Country:US
Mailing Address - Phone:410-661-2448
Mailing Address - Fax:
Practice Address - Street 1:8710 EMGE RD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-3504
Practice Address - Country:US
Practice Address - Phone:410-661-2448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06104225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist