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Organization
SOVEREIGNTY HEALTH SERVICES LLC
Active
Organization
SOVEREIGNTY HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEHINDE M TIJANI OTR/L (OCCUPATIONAL THERAPIST)
(410) 940-1983
Entity
Organization
Contact information
Practice address
1319 WOODBRIDGE STATION WAY UNIT 102, EDGEWOOD, MD 21040-3852
(410) 940-1983
Mailing address
152 SPECTATOR LN, OWINGS MILLS, MD 21117-4444
(410) 940-1983
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
NULL
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
02/26/2020
Last updated
03/07/2020
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