Individual
LUIS FERNANDO MEJIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
7355 E FURNACE BRANCH RD, GLEN BURNIE, MD 21060-7060
(410) 766-3460
(410) 760-6947
Mailing address
7355 E FURNACE BRANCH RD, GLEN BURNIE, MD 21060-7060
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A02647
MD
Other
Enumeration date
07/16/2019
Last updated
07/16/2019
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