Provider Demographics
NPI:1346846110
Name:SILVA MANRIQUE, CECILIA IVETTE (PT, DPT)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:IVETTE
Last Name:SILVA MANRIQUE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17707 SILKCOTTON WAY
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-1041
Mailing Address - Country:US
Mailing Address - Phone:301-968-5366
Mailing Address - Fax:
Practice Address - Street 1:20410 OBSERVATION DR STE 205
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-6422
Practice Address - Country:US
Practice Address - Phone:301-528-8096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28210225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist