Provider Demographics
NPI:1083836316
Name:KEMPERS, MYLENE A (PT)
Entity type:Individual
Prefix:
First Name:MYLENE
Middle Name:A
Last Name:KEMPERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2001 WARNERS TER N UNIT 312
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-8775
Mailing Address - Country:US
Mailing Address - Phone:410-224-7237
Mailing Address - Fax:410-224-7237
Practice Address - Street 1:8965 GUILFORD RD STE 160
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2396
Practice Address - Country:US
Practice Address - Phone:410-796-8499
Practice Address - Fax:443-270-8260
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD183232251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics