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Individual

KEISHA JENNINGS-EAKIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
658 BOULTON ST, BEL AIR, MD 21014-4214
(301) 581-8054
(301) 564-0284
Mailing address
2962 COLCHESTER CT, ABINGDON, MD 21009-1922
(443) 402-5490
(434) 420-6747

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
06121
MD
225X00000X
Occupational Therapist
Primary
T00599
MD
225XE0001X
Environmental Modification Occupational Therapist
06121
MD
225XG0600X
Gerontology Occupational Therapist
06121
MD
225XR0403X
Driving and Community Mobility Occupational Therapist
06121
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
131611257
MD
Enumeration date
04/29/2008
Last updated
09/22/2020
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