Provider Demographics
NPI:1770063174
Name:UAGBOR, SYLVA GRAVES (MSOTR/L)
Entity type:Individual
Prefix:
First Name:SYLVA
Middle Name:GRAVES
Last Name:UAGBOR
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5030 HILLTOP ACRES RD
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-9629
Mailing Address - Country:US
Mailing Address - Phone:410-307-1295
Mailing Address - Fax:
Practice Address - Street 1:531 STEVENSON LN
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-7607
Practice Address - Country:US
Practice Address - Phone:410-307-1295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08157225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD08157OtherMARYLAND BOARD OF OCCUPATIONAL THERAPY PRACTICE