Provider Demographics
NPI:1730394974
Name:POORE, LINDA ANNE (OTR)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ANNE
Last Name:POORE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:ANNE
Other - Last Name:KOPF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:930 FOREST BAY CT
Mailing Address - Street 2:
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054-1603
Mailing Address - Country:US
Mailing Address - Phone:410-451-1231
Mailing Address - Fax:410-451-8452
Practice Address - Street 1:140 STEPNEY LN
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-2801
Practice Address - Country:US
Practice Address - Phone:410-956-3559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02199225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics