Individual
GINA MODERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
11175 GEORGIA AVE, APT 236, SILVER SPRING, MD 20902-4605
(315) 934-3301
Mailing address
11175 GEORGIA AVE, APT 236, SILVER SPRING, MD 20902-4605
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT010000833
DC
Other
Enumeration date
06/16/2014
Last updated
06/16/2014
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