Individual
KATHERINE CHILDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1651 CROFTON BLVD STE 14, CROFTON, MD 21114-1314
(410) 721-6650
Mailing address
1517 HORNBEAM DR, CROFTON, MD 21114-3244
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20176
LICENSE #
MD
Enumeration date
09/28/2006
Last updated
07/08/2007
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