Provider Demographics
NPI:1841497328
Name:FINE, MAUREEN CHRISTA (PTA)
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:CHRISTA
Last Name:FINE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2509 KNIGHTHILL LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-2754
Mailing Address - Country:US
Mailing Address - Phone:301-464-9306
Mailing Address - Fax:
Practice Address - Street 1:14502 GREENVIEW DR STE 406
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-4220
Practice Address - Country:US
Practice Address - Phone:866-566-5310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA1088225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant