Individual
MRS. AUTUMN R WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L, CLT
Contact information
Practice address
157 BALTIMORE ST, CUMBERLAND, MD 21502-2319
(301) 722-3215
Mailing address
220 MILLER ST, WESTERNPORT, MD 21562-1711
(301) 359-8955
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119004134
VA
225X00000X
Occupational Therapist
Primary
05586
MD
225X00000X
Occupational Therapist
OC009784
PA
Other
Enumeration date
07/31/2006
Last updated
09/24/2008
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