Provider Demographics
NPI:1194275388
Name:REAMES, SELENA M (OTR/L)
Entity type:Individual
Prefix:
First Name:SELENA
Middle Name:M
Last Name:REAMES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17834 LOCHNESS CIR
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-2303
Mailing Address - Country:US
Mailing Address - Phone:301-503-0497
Mailing Address - Fax:
Practice Address - Street 1:808 OLNEY SANDY SPRING RD
Practice Address - Street 2:
Practice Address - City:SANDY SPRING
Practice Address - State:MD
Practice Address - Zip Code:20860-1055
Practice Address - Country:US
Practice Address - Phone:301-503-0497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07878225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist