Provider Demographics
NPI:1174929905
Name:LESTER, BERNADETTE THERESE (OTR/L)
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:THERESE
Last Name:LESTER
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 1:5509 SOLOMONS ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:LOTHIAN
Mailing Address - State:MD
Mailing Address - Zip Code:20711-9705
Mailing Address - Country:US
Mailing Address - Phone:410-867-7759
Mailing Address - Fax:
Practice Address - Street 1:5509 SOLOMONS ISLAND RD
Practice Address - Street 2:
Practice Address - City:LOTHIAN
Practice Address - State:MD
Practice Address - Zip Code:20711-9705
Practice Address - Country:US
Practice Address - Phone:410-867-7759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02031225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist