Provider Demographics
NPI:1336529502
Name:LOW VISION OCCUPATIONAL THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:LOW VISION OCCUPATIONAL THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST, OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LIND
Authorized Official - Middle Name:G
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, SCLV, MS
Authorized Official - Phone:443-798-2930
Mailing Address - Street 1:11440 LITTLE PATUXENT PKWY
Mailing Address - Street 2:APT 708
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3773
Mailing Address - Country:US
Mailing Address - Phone:443-798-2930
Mailing Address - Fax:443-798-2922
Practice Address - Street 1:11440 LITTLE PATUXENT PKWY
Practice Address - Street 2:APT 708
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3773
Practice Address - Country:US
Practice Address - Phone:443-798-2930
Practice Address - Fax:443-798-2922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-03
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01162225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty