Individual
MRS. LAURA BAZZELL PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
205 ARMSTRONG ST, CENTREVILLE, MD 21617-2125
(410) 758-2323
Mailing address
320 FAIRVIEW DR, CHESTERTOWN, MD 21620-2814
(410) 778-4214
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A0143
MD
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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