Provider Demographics
NPI:1770611394
Name:THE MARYLAND THERAPY NETWORK, INC
Entity type:Organization
Organization Name:THE MARYLAND THERAPY NETWORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NOPLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-515-4900
Mailing Address - Street 1:2225 OLD EMMORTON ROAD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6123
Mailing Address - Country:US
Mailing Address - Phone:410-515-4900
Mailing Address - Fax:410-515-0777
Practice Address - Street 1:2225 OLD EMMORTON ROAD
Practice Address - Street 2:SUITE 210
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6123
Practice Address - Country:US
Practice Address - Phone:410-515-4900
Practice Address - Fax:410-515-0777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKT07MAOtherCAREFIRST BCBS