Individual
ELIZABETH SCHUELLER WASSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
415 MARKET ST, HAVRE DE GRACE, MD 21078-3301
(410) 939-5500
Mailing address
247 FOUNTAIN ST APT C, HAVRE DE GRACE, MD 21078-3238
(410) 937-2559
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A00789
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A00789
OTA LICENSE
MD
Enumeration date
05/05/2019
Last updated
05/05/2019
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