Provider Demographics
NPI:1528307014
Name:OKORO, CHIMELA (OTR/L)
Entity type:Individual
Prefix:
First Name:CHIMELA
Middle Name:
Last Name:OKORO
Suffix:
Gender:M
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 1:4680 PRESTANCIA PL
Mailing Address - Street 2:APT. 102
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-4137
Mailing Address - Country:US
Mailing Address - Phone:717-440-7760
Mailing Address - Fax:301-638-2986
Practice Address - Street 1:4680 PRESTANCIA PL
Practice Address - Street 2:APT. 102
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-4137
Practice Address - Country:US
Practice Address - Phone:717-440-7760
Practice Address - Fax:301-638-2986
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06939225X00000X
NY012885-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist