Individual
THERESA SHOLTIS DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O. T.
Contact information
Practice address
197 THOMAS JOHNSON DR STE B, FREDERICK, MD 21702-4314
(301) 662-1997
Mailing address
197 THOMAS JOHNSON DR STE B, FREDERICK, MD 21702-4314
(301) 662-1997
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
03093
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KBC4H0-61389202
BC/BS OF MARYLAND
MD
01
—
S404-0006
CAREFIRST BC/BS
MD
Enumeration date
08/03/2006
Last updated
02/27/2020
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