# SPECIALTY PAIN MANAGEMENT SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316516909
- **Authorized official:** MS. LYDIA BONGIORNI OTR/L (OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (443) 472-2449

## Contact information

- **Practice address:** 8008 NIGHTWIND CT, ELKRIDGE, MD 21075-6463
- **Practice address phone:** (410) 404-6071
- **Mailing address:** 8008 NIGHTWIND CT, ELKRIDGE, MD 21075-6463
- **Mailing address phone:** (410) 404-6071

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225XN1300X | Neurorehabilitation Occupational Therapist | — | NULL | — |
| 225XN1300X | Neurorehabilitation Occupational Therapist | — | — | — |
| 225XP0019X | Physical Rehabilitation Occupational Therapist | — | NULL | — |
| 225XP0019X | Physical Rehabilitation Occupational Therapist | — | — | — |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/18/2021
- **Last updated:** 03/08/2023