Individual
MEGUMI OTAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
300 INTERNATIONAL CIR, COCKEYSVILLE, MD 21030-1300
(410) 527-1111
Mailing address
PO BOX 680, RIDERWOOD, MD 21139-0680
(937) 602-3501
(214) 305-3399
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
06030
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06030
—
MD
Enumeration date
04/26/2019
Last updated
04/26/2019
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