Provider Demographics
NPI:1740987718
Name:DRAKE, VICTORIA (OTR/L)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:DRAKE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5357 S CENTER DR
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-4099
Mailing Address - Country:US
Mailing Address - Phone:865-773-8586
Mailing Address - Fax:
Practice Address - Street 1:4833 RUGBY AVE STE 501
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3910
Practice Address - Country:US
Practice Address - Phone:301-523-0902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09899225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist