Provider Demographics
NPI:1295154334
Name:SPOELMAN, LEAH
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:SPOELMAN
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:PO BOX 37687
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3687
Mailing Address - Country:US
Mailing Address - Phone:240-575-6983
Mailing Address - Fax:301-668-7008
Practice Address - Street 1:4990 BOILING BROOK PKWY
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2300
Practice Address - Country:US
Practice Address - Phone:301-816-9500
Practice Address - Fax:301-668-7008
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07362225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics