Individual
MR. KENROY GREENIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
1801 WENTWORTH RD, BALTIMORE, MD 21234-6128
(410) 661-5717
Mailing address
107 SUMMER WOODS WAY, OWINGS MILLS, MD 21117-1777
(410) 902-1379
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A01557
MD
Other
Enumeration date
10/11/2007
Last updated
10/11/2007
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