Provider Demographics
NPI:1649988601
Name:ALEMU, BINIAM A (COTA)
Entity type:Individual
Prefix:
First Name:BINIAM
Middle Name:A
Last Name:ALEMU
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6637 LOCH HILL RD
Mailing Address - Street 2:
Mailing Address - City:LOCH HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21239-1645
Mailing Address - Country:US
Mailing Address - Phone:443-563-8133
Mailing Address - Fax:
Practice Address - Street 1:6637 LOCH HILL RD
Practice Address - Street 2:
Practice Address - City:LOCH HILL
Practice Address - State:MD
Practice Address - Zip Code:21239-1645
Practice Address - Country:US
Practice Address - Phone:443-563-8133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD393700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist