Provider Demographics
NPI:1972816072
Name:BAGUIO, TERESITA
Entity type:Individual
Prefix:
First Name:TERESITA
Middle Name:
Last Name:BAGUIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10015 OLD COLUMBIA RD
Mailing Address - Street 2:SUITE B-215
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1703
Mailing Address - Country:US
Mailing Address - Phone:410-312-7631
Mailing Address - Fax:410-510-1779
Practice Address - Street 1:10 N ROCK GLEN RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-3250
Practice Address - Country:US
Practice Address - Phone:410-646-2100
Practice Address - Fax:410-510-1779
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-17
Last Update Date:2010-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD183632251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics