Individual
DR. ELDORNA SAMUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
10000 RUNNING SAND KNL, LAUREL, MD 20723-5783
(301) 641-7035
(301) 850-7613
Mailing address
10000 RUNNING SAND KNL, LAUREL, MD 20723-5783
(301) 641-7035
(301) 850-7613
Taxonomy
Speciality
Code
Description
License number
State
225XE0001X
Environmental Modification Occupational Therapist
Primary
03803
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
510074700
—
MD
Enumeration date
02/19/2014
Last updated
02/19/2014
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