Provider Demographics
NPI:1053751008
Name:MEREDITH, YAEL Y
Entity type:Individual
Prefix:
First Name:YAEL
Middle Name:Y
Last Name:MEREDITH
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 1:18113 BILNEY DR
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-2813
Mailing Address - Country:US
Mailing Address - Phone:202-299-6314
Mailing Address - Fax:
Practice Address - Street 1:1401 OLNEY SANDY SPRING RD
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832
Practice Address - Country:US
Practice Address - Phone:202-299-6314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-04
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06758225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
210058Medicare PIN