Provider Demographics
NPI:1720167547
Name:NASUTA, DARLENE (OT)
Entity Type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:
Last Name:NASUTA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8320 BELLONA AVE
Mailing Address - Street 2:SUITE 40
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2022
Mailing Address - Country:US
Mailing Address - Phone:410-346-5776
Mailing Address - Fax:410-346-5986
Practice Address - Street 1:8320 BELLONA AVE
Practice Address - Street 2:SUITE 40
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2022
Practice Address - Country:US
Practice Address - Phone:410-346-5776
Practice Address - Fax:410-346-5986
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01758225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist