Individual
MS. MANGALA BALU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
7615 WASHINGTON BLVD, ELKRIDGE, MD 21075-6443
(410) 579-2626
Mailing address
2408 SOMMERS CT, JESSUP, MD 20794-9818
(443) 829-6587
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
06/06/2025
Last updated
06/06/2025
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