Basic Information
| Provider Information | |||||||||
| NPI: | 1295796357 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HYNES | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | GENEVIEVE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | OTR-L, CHT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 219 S WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | EASTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216012913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108221000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10 MARTIN CT | ||||||||
| Address2: | |||||||||
| City: | EASTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 216013833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108223080 | ||||||||
| FaxNumber: | 4108200003 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2006 | ||||||||
| LastUpdateDate: | 06/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 01876 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.