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Individual

LYDIA ELAINE WIVELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, OTR/L

Contact information

Practice address
350 MONTEVUE LN, FREDERICK, MD 21702-8214
(301) 600-1611
Mailing address
130 MARSH CREEK ROAD, GETTYSBURG, PA 17325
(301) 418-8415

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
09500
MD

Other

Enumeration date
01/01/2022
Last updated
02/20/2026
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